Τόμος 1 (1983) – Τεύχος 2 – Άρθρο 1 – Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση – Volume 1 (1983) – Issue 2– Article 1 – Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Τίτλος – Title Χρήση φαρμάκων κατά την Τρίτη Ηλικία

Drugs in the elderly

Συγγραφέας – Author Σταύρος Τ. Πλέσσας

Stavros T. Plessas

Παραπομπή – Citation Πλέσσας, Σ.Τ.: Χρήση φαρμάκων κατά την Τρίτη Ηλικία, Επιθεώρηση Κλιν. Φαρμακολ. Φαρμακοκινητ. 2: 84-101 (1983)

Plessas, S.T.: Drugs in the elderly, Epitheorese Klin. Farmakol. Farmakokinet. 2: 84-101 (1983)

 

Ημερομηνία Δημοσιευσης – Publication Date Ιούλιος – 1983 – July 1983
Γλώσσα Πλήρους Κειμένου –
Full Text Language
Ελληνικά – Greek
Παραγγελία – Αγορά –
Order – Buy
Ηλεκτρονική Μορφή: pdf (15 €) –
Digital Type: pdf (15 €)
pharmakonpress[at]pharmakonpress[.]gr
Λέξεις κλειδιά – Keywords Υπερήλικες, ασθενείς, φάρμακα, νόσος, δοσολογία, ανταπόκριση, απορρόφηση

Elderly persons, patients, drugs, illness, dose, responsiveness, absorption

Λοιποί Όροι – Other Terms Άρθρο
Article
Περίληψη – Summary The elderly persons (60 years of age and over) constitute an increasing proportion of patient population. As a group, elderly patients have more illness, take more drugs and they are particurarly susceptible to adverse drug reactions than younger patients. In elderly the responsiveness to drugs is altered because of changes in the pharmacokinetics and pharmacodynamics and of influence of accociated deseases. The rate or the amount of drug absorbed from the gastrointestinal tract are probably unaltered. The elderly differs from the young in the quantity of drug delivered to the target-site because of alteration in the processes of drug distribution and elimination. These processes are affected by the changes in body composition (decrease in lean body mass, total body water and serum albumin), in cardiac output, in liver and cerebral blood flow (diminished) and in glomerular and tubular function of the kindney (declined). The clinician should realize that many diseases from which the elderly patient suffers do not require drug treatment and must, also, take particular care of the added risks for these patients in the case that a drug therapy is decided. Only those drugs which the patient really needs should be prescribed. In general, the elderly patients require smaller doses of drugs than are given to the young adults. Drugs usually given in reduced doses  include aminoglycosides, benzodiazepines, carbamazepine, chlormethiazole, digoxin, haloperidol, levodopa, metoclopramide, pethidine, thioridazine, thyroxine and vitamin D. Other drugs, as barbiturates, bethanidine, carbenoxoione, chrolpropamide, hlorthalidone, debrisoquine, guanethidine, nitrofurantoin, pentazocine and phenylbutazone should be avoided as possible. Dose regimens should be as simple aspossibie (special packaging, clear labelling) and drug therapy should be managed by a responsible neighbour or relative.
Αναφορές – References 1.        Sutler, R.N.: The gray revolution and health. American pharmacy NS20(5): 9 ( 1980)

2.         Crooks, J., Stevenson, I.H. (Eds): Drugs and the Elderly. Macmillan, London, 1979

3.         Beck, H., Berthaux, P,: Vieillissement biologique et médicament. Revue de gériatrie 5: 69 (1980)

4.         De Cier, J.J.: Veranderingen infarmacodynamie enfarmacokeinetiek bij de ouder wordende mens. In: (Coedhazd, W.J.A., Knook, D.L., ed) Geneesmiddelen en Ouder worden, Brussels, Stafleu, Alphen aan den Rijn, 1980

5.         Vestal, R.E.: Drug use inthe elderly: Areview of problems and special considerations. Drugs 16: 358 (1978)

6.         Williamson, J., Chopin, J.M.: Adverse reactions to prescribed drugs in the elderly: a multicentre investigation. Age and ageing 9: 73 (1980)

7.         World Health Organization; Technical Advisory Committee on Health Care of the Elderly, ICP/ADR 018, Copenhagen (1978)

8.         World Health Organization: Studies in Drug Utilization, Eur. Ser. No 8, Copenhagen (1979)

9.         World Health Organization: Ninth Symposium on Clinical Pharmacological Education in Drug Control, Copenhagen (1981)

10.       World Health Organization: Health care in the elderly. Report of the Technical Groupon use of medicaments bythe elderly. Thônex, September, 1980

11.        Πλέσσας, Σ.Τ.:Δόσεις-συγκεντρώσεις και ανταπόκριση των φαρμάκων. Επιθ. Κλιν. Φαρμακολ. – φαρμακοκ. 1:42 ( 1983)

12.       Crooks, J.: O’Malley, K., Stevenson, I.H.: Pharmacokinetics in the elderly. Clin. Pharmacok. 1: 280

13.       Bender, A.D.: Effect of age on intestinal absorption: Implications for drug absorption in the elderly. J. Am. Ger. Soc. 16: 1331 (1968)

14.       Edelman, I.S., Leibman, J.: Anatomy of body water and electrolytes. Am. J. Med. 27:256 (1959)

15.       Forbes, C.B., Reina, J.C.: Adult lean body mass declines with age: Some longitudinal observations. Metabolism 19: 653 (1970)

16.       Novak, L.P.: Aging, total body potassium, fat-free mass, and cell mass in males and females between ages 18 and 35 years. J. Ger. 27:438 (1972)

17.       Woodford-Willtams, E.: Webster, D.: Landless, B., Dixon, M.       P.: Serum protein patterns in normal· and pathological aging. Ger. Clin 10: 86 (1968)

18.       Cammarata, R.J., Rodnan, G.P., Fennell, R.H.: Serum anti-gamma-globulin and anti-nuclear factors in the aged.*/. Am, Med. Ass. 199: 115 (1967)

19.       Ceokas, M.C., Haverback, B.J.: The aging gastrointestinal tract. Am. J. Surg. 117: 881 (1969)

20.      Kato, R., Takanaka, A.: Metabolism of drugs in old rats. I. Activities of NAD PH-I inked electron transport and drug metabolizing enzyme systems in livermlcrosomesofold rats. Jap. J. Pharmacol. 18: 381 (1968)

21.       Γλωσσάρι: Επιθ. Κλιν. Φαρμακολ. Φαρμακοκ. 1:72(1983)

22.       Nies, A.S.: Shand, D.B., Wilkinson, G.R.: Altered hepatic blood flow and drug disposition. CHn. Pharmacok. 1: 125 (1976)

23.       Wilkinson, G.R.: Effects of liver disease and ageing on the disposition of diazepam, chlordiazepoxide, oxazepam and lorazépam in man. Acta Psych. Scand. S274: 56 (1978)

24.       Salem, S., Rajjayabum, P., Shepherd, A.M.M., Stevenson, I.H.: Reduced induction of drug metabolism in the elderly. Age and Ageing 7: 68 (1980)

25.       Vestal, R.E., Norris, A.H., Tobin, J.D.: Cohen, B.H.: Shock, N.         W., Andres, R.: Antipyrine metabolism in man: Influence of age, alcohol, caffeine, and smoking. CUn Pharmacol. Ther: 18: 425 (1975)

26.       Hayes, M J.: Langman, M.J.S., Short, A.H.: Changes in drug metabolism with increasing age. II. Phenytoin clearance and protein binding. Br.J. Clin. Pharmacol. 2: 69 (1975)

27.       Hayes, M J., Langman, M.J.S., Short, A.H.: Changes in drug metabolism with increasing age. I. Warfarin binding and plasma proteins. Br. J. Clin. Pharmacol. 2: 73 (1975)

28.      Farah, F., Taylor, W., Rawlins, M., James, 0.: Hepatic drug acetylation and oxidation: Effects of aging in man. Sr. Med.J. 11: 155 (1977)

29.       Castleden, C.M.: Prescribing for the elderly, Prescribers J. 18:90(1978)

30.      Rowe, J.W., Andres, R„Tobin, J.D., Noris,A.H.,Shock, N.W.: The effect of age on creatinine clearance in man: A cross-sectional and longitudinal study. J. Ger. 31: 155 (1976)

31.       Bender, A.D.: The effect of increasing age on the distribution of peripheral blood flow in man. J. Am. Ger. Sac. 13: 192 (1965)

32.       Molholm-Hansen, J., Kampmann, J., Laursen, H.: Renal excretion of druygs in the elderly. Lancet l: 1170 (1970)

33.       Bender, A.D.: Pharmacologic aspects of aging. A survey of the effect of age on drug activity in adults. J. Am. Ger. Soc. 12: 114 (1964)

34.       Hall, M.R.P.: Drug therapy in the elderly. Br. Med.J.3:582 (1973)

35.       Anderson, W.F.: Administration, labelling and general principlesofdrugprescription in theelderly.Ger. Clin. 16:4(1974)

36.       Freeman, J.T.: Some principles of medication in geriatrics. J. Am. Ger. Soc. 22: 289 (1974)

37.       Holloway, D.: Drug problems in the geriatric patient. Drug Intelligence and Clinical Pharmacy 8: 632 (1974)

38.      Learoyd, B.M.: Psychotropic drugs and the elderly patient. /Wed.J.Ausf/,-1131 (1972)

39.       Burr, M.L., King,S„ Davies, H.E.F., Pathy, M.S.: The effects of discontinuing long term diuretic therapy in the eldetly. Ape and Ageing 6: 38 (1977)

40.      Parkin, D.M., Henney, C.R., Quirk, J., Crooks, J.: Deviation from prescribed drug treatment after discharge from hospital. Br. Med. J. 2: 686 (1976)

41.       Schwartz, D., Wang, M., Feitz, L, Goss, M.E.W.: Medication errors made by elderly, chronically ill patients. Am. J. Pub. Health 52: 2018 (1962)

42.       Mazullo, J.M.: The nonpharmacologic basis of therapeutics. CUn. Pharmacol. Ther. 13: 157 (1972)

43.       Ayd, F.J.: Single daily dose of antidepressants. J.Am. Med. Assoc. 230: 263(1974)

44.       Law, R., Chambers, C.:Medicinesand elderly people: Ageneral practice survey. Br. Med. J. 1, 565 (1976)

45.       Gibson, I.I., O’Xare, M.O.: Prescription of drugsforold people at home. Ger. CUn. 70:271 (1968)

46.       Ogilvie, R.I., Ruedy, J.: An educational program in digitalis therapy. J. Am. Med. Assoc. 222: 50 (1972)

47.       Chamberlain, D.A:: White, R.J., Howard, M.R., Smith, T.W.: Plasma digoxin concentrations in patients with atrial fibrillation. Br. Med.J. 3:429 (1970)

48.      Dall,J.L.C.: Digitalis intoxication in elderly patients, Cancei 1: 194 (1965)

49.       Lely, A.H., Van Enter, C.H.J.: Non-cardiac symptoms of digitalis intoxication. Am. Heart. J. 83: 149 (1972)

50.       Landahl, S., Lindblad, B., Roupe, S., Steen, B., Svanborg, A.: Digitalis therapy in a 70-year-old population. Acta Med. Scand.202: 437(1977)

51.       Cheung, A., Kayne, R.: An application of clinical pharmacy services in extended care facilities. California Pharmacist 23: 22-25ff (Sept. 1975)

52.       Caird, F.I.: Andrews, G.R., Kennedy, R.D.: Effect of posture on blood pressure in the elderly. Br. Heart. J. 35: 527 (1973)

53.       Dali, J.L.C., Paulóse, S., Fergusson, J.A.: Potassium intake of elderly patients in hospital. Ger. Clin. 13: 114 (1971 )

54.       Jackson, G., Mahon, W., Pierscianowski, T.A., Condon, J.: Inappropriate antihypertensive therapy in the elderly. Lancet 2: 1317 (1976)

55.       Grtbbon, B., Pickering, T.G., Sleight, P., Peto, R.: Effect of age and high blood pressure on baroreflex sensitivity in man. Circulation Research 29: A2A (1971)

57.       Dyer, A.R., Stamler, J., Shekelte, R.B., Schoenberger, J.A., Farinaro, E.: Hypertension in the elderly. Med. din. North Amer. 61: 513 (1977)

58.       Dollery, C.T., Harington, J.: Methyldopa in hypertension. Clinical and pharmacological studies. Lancet 1: 759 (1962)

59.       Jellett, LB.: Potassium therapy: When is it indicated? Drugs 16:88 (1978)

60.      O’Malley, K., Stevenson, I.H., Ward, C.A., Wood, A.J., Crooks, J.: Determinants of anticoagulant control in patients receiving warfarin. Br. J. CUn. Pharmacol. 4: 309 (1977)

61.       Husted, S., Andreasen, F.: The influence of age on the response to anticoaqulants. Br. J. CUn. Pharmacol. 4: 559 (1977)

62.       Shepherd, A.M.M., Hewick, D.S., Moreland,T.A.,Stevenson, I.M.: Age as a determinant of sensitivity to warfarin. Br. J. CUn. Pharmackol. 4: 315 (1977)

63.       Castleden, C.M., Kaye, C.M., Parsons, R.L: The effect of age on plasma levels of propranolol and practolol in man, Br. J. Clin. Pharmacol. 2:303 (1975)

64.       Wood, A.J.J., Vestal, R.E., Branch, R.A., Wilkinson, G.R., Shand, D.G.: Are related effectsof smoking on elimination of propranolol, antipyrine and indocyanine green (Abst). Clinical Research 26:14A (1978)

65.       Vesta), R.E., Wood, A.J.J.,Shand, D.G.: Reducedp-andrenoceptor sensitivity in the elderly (Abst). Clinical Research 26: 488A (1978)

66.       McDevitt, D.G., Frisk-Holmberg, M., Holiifield, J.W., Shand D.G.: Plasma bindind and the affinity of propranolol fora beta receptor in man. CUn. Pharmacol. Ther. 20: 152 (1976)

67.       Nation, R.L,Triggs, E.J., Selig, M.: Lignocaine kinetics in cardiac patients and aged subjects. Br. J. CUn. Pharmacol. 4: 439 (1977)

68.      Pfeifer, H.J., Greenblatt, DJ„ Koch-Weser, J.: Clinical use and toxicity of intravenous lidocaine. Am. Heart J. 92:168 (1976)

69.       Ochs, H.R., Greenblatt, D.J., Woo, E., Fránke, K.,Smith,T.W.: Reduced clearance of quinidine in elderly humans (Abst). Clinical Research 25: 513A (1977)

70.       Galeazzi, R.L.: The effect of an antacid on the bioavailability of indomethacin. Bur. J. CUn. Pharmacol. 12: 65 (1977)

Online ISSN 1011-6575

Άρθρα Δημοσιευμένα σε αυτό το Περιοδικό Καταχωρούνται στα:

Articles published in this Journal are Indexed or Abstracted in:
• Chemical Abstracts
• Elsevier’s Bibliographic Databases: Scopus, EMBASE, EMBiology, Elsevier BIOBASE
SCImago Journal and Country Rank Factor

Τι είναι η Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση-Οδηγίες προς τους Συγγραφείς 
What is Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition-Instrunctions to Authors

Άρθρα Δημοσιευμένα στην Επιθεώρηση Κλινικής Φαρμακολογίας και Φαρμακοκινητικής-Ελληνική Έκδοση
Articles Published in Epitheorese Klinikes Farmakologias και Farmakokinetikes-Greek Edition

Συντακτικη Επιτροπή-Editorial Board

ΕΤΗΣΙΑ ΣΥΝΔΡΟΜΗ 1983 – ANNUAL SUBSCRIPTION 1983
Γλώσσα Πλήρους Κειμένου – 
Full Text Language
Ελληνικά – Greek
Παραγγελία – Αγορά –
Order – Buy
Ηλεκτρονική Μορφή: pdf (70 €) –
Digital Type: pdf (70 €)pharmakonpress[at]pharmakonpress[.]gr
Έντυπη Μορφή (70 € + έξοδα αποστολής)
Printed Type (70 € + shipping)pharmakonpress[at]pharmakonpress[.]gr

 

 

Προσθέστε στους σελιδοδείκτες το μόνιμο σύνδεσμο.

Τα σχόλια είναι απενεργοποιημένα.