在老年急诊室患者的第一代抗胰岛素使用:回顾性审查.
Emily Killen1, Michael Cusumano1, Zidong Zhang2
1Saint Louis University School of Medicine, St. Louis, Missouri.
The western journal of emergency medicine
|January 19, 2026
概括
第一代抗组胺剂通常用于老年人急诊室,但具有风险. 大多数使用是不合适的,并且发生了像痴呆症这样的不良药物效应,特别是在85岁以上或认知障碍的人群中.
科学领域:
- 老年急救医学的医学
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 第一代抗胰岛素在急诊室 (ED) 中很常见,但对老年人来说存在风险.
- 有限的ED特异性数据存在于药物不良反应 (ADEs) 和单剂量管理的风险在这个人群中.
- 这项研究评估了在ED访问期间老年人的第一代抗组胺剂的使用,ADEs和适用情况.
研究的目的:
- 评估在ED中老年人使用第一代抗组胺药物的频率.
- 确定与药物使用相关的不良药物效应的发生率和类型.
- 为了确定抗组胺剂在这个人口群体中适用的适用性.
主要方法:
- 在城市学术医疗中心接受第一代抗胰岛素的65岁以上成年人的回顾性队列研究ED.
- 盲目的抽象者对图表进行审查,以确定指示和不良影响.
- 回归分析用于评估与不良药物影响相关的因素,包括年龄 (≥85),认知障碍和多次剂量.
主要成果:
- 第一代抗组胺剂在3%的老年人ED遭遇中使用.
- 药物不良反应发生在15%的遭遇中, Delirium 和尿路保留是最常见的.
- 年龄≥85,先前的认知障碍和多次剂量显著增加了ADE风险 (RR分别为5.5,3.1和1.9).
- 92%的适应症是潜在的不适当的,包括用于头痛或对比介质反应的迪芬胺和用于焦虑的氧.
结论:
- 在老年人中,急诊室使用第一代抗组胺剂与临床上显著的伤害有关,特别是在≥85或认知障碍患者中.
- 在这个队列中,大多数抗组胺剂的使用是针对可能不合适的适应症.
- 用于预防对比介质反应的二水胺是一种常见的,可能不合适的指示.
更多相关视频
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
16.8K
09:52Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide
Published on: January 15, 2017
17.6K
相关概念视频
01:15Drug Dosing: Geriatric Patients
229
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...
229
01:15Upper Respiratory Drugs: First and Second-Generation Antihistamines
1.1K
Antihistamines are a class of drugs widely used to alleviate the symptoms of allergies, such as sneezing, itching, and nasal congestion. They work by inhibiting the actions of histamine, which is released by immune cells in response to allergenic substances or tissue injuries.
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...
Histamine binds to specific receptor sites, known as H1 receptors, on tissue cells, triggering inflammation and swelling. Antihistamines combat these effects by competing with histamine for these receptor sites. By...
1.1K
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
191
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...
191
01:00Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution
234
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
234
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
198
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
198
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
240
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...
240