在美国,Gabapentinoid-Loop-Diuretic处方布的预测者. 养老院居民 养老院居民
Kaleen N Hayes1,2,3, Emmanuelle Belanger1,2, Arman Oganisian4
1Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.
Journal of the American Geriatrics Society
|November 28, 2025
概括
大约在20个养老院居民中,大约1个开始服用 gabapentinoids 的人在90天内接受循环利尿剂. 更高的 gabapentinoid 剂量和多种药品增加了这种处方级联风险.
科学领域:
- 老年医学 老年医学
- 药理学 药理学 是一个学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 来自 gabapentinoids 的周围胀可能导致循环利尿剂处方.
- 养老院居民特别容易受到这种处方级联的影响.
- 了解这种级联的预测因素对于患者的安全至关重要.
研究的目的:
- 为了估计 gabapentinoid-loop 利尿剂在养老院居民中处方布的发生率.
- 为了确定这种处方级联的预测因素.
主要方法:
- 使用医疗保险索赔和最低数据集评估 (2016-2022) 的回顾性队列研究.
- 已确定年龄≥66岁的养老院住户开始服用 gabapentinoids,没有先前使用循环利尿剂,心力衰竭或功能不全.
- 分析了在90天内使用多变量Poisson和聚合后勤回归模型的循环利尿剂启动.
主要成果:
- 4.2%的居民经历了布,平均时间为36天.
- 预测因素包括老年,慢性疼痛,糖尿病以及使用其他利尿剂或≥15种药物.
- 较高的每周 gabapentinoid 剂量增加了级联风险;认知障碍显示出一种保护性关联.
结论:
- 在20个养老院居民中,大约有1个开始服用 gabapentinoids 的人在3个月内接受循环利尿剂.
- 多药和不断升级的 gabapentinoid 剂量是可修改的风险因素.
- 临床医生应该在添加循环利尿剂之前监测并考虑剂量调整.
相关概念视频
01:15Drug Dosing: Geriatric Patients
212
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
212
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
221
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
221
01:22Heart Failure Drugs: Diuretics
768
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
768
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
222
Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
222
01:28Antihypertensive Drugs: Potassium-Sparing Diuretics
2.2K
Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
2.2K
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
180
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
180