衰老对老年患者长期用药药效学和药代动力学的影响:综述。

IF 4.6 2区 医学 Q1 PHARMACOLOGY & PHARMACY
Nokwanda N Ngcobo
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引用次数: 0

摘要

随着人们年龄的增长,确保细胞和器官之间适当交流的各种调节过程的效率趋于下降。这种恶化会导致在生理压力下维持体内平衡的困难。这包括但不限于认知障碍、功能障碍以及与护理人员相关的问题,这些问题对药物错误和不依从性有重大影响。这些因素可导致更高的发病率,延长住院时间,降低生活质量,甚至死亡。体内平衡能力的下降因个体而异,导致在老年人群中观察到更大的变异性。显著的药代动力学和药效学变化伴随着衰老。药代动力学变化包括肾和肝清除率降低,脂溶性药物分布体积增加,从而延长其消除半衰期。药效学变化通常包括对各种药物的敏感性增加,如抗凝血剂、抗糖尿病药物和精神药物。本文综述了老年医学中与年龄相关的主要生理变化及其对药物的药代动力学和药效学的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of Ageing on the Pharmacodynamics and Pharmacokinetics of Chronically Administered Medicines in Geriatric Patients: A Review.

As people age, the efficiency of various regulatory processes that ensure proper communication between cells and organs tends to decline. This deterioration can lead to difficulties in maintaining homeostasis during physiological stress. This includes but is not limited to cognitive impairments, functional difficulties, and issues related to caregivers which contribute significantly to medication errors and non-adherence. These factors can lead to higher morbidity, extended hospital stays, reduced quality of life, and even mortality. The decrease in homeostatic capacity varies among individuals, contributing to the greater variability observed in geriatric populations. Significant pharmacokinetic and pharmacodynamic alterations accompany ageing. Pharmacokinetic changes include decreased renal and hepatic clearance and an increased volume of distribution for lipid-soluble drugs, which prolong their elimination half-life. Pharmacodynamic changes typically involve increased sensitivity to various drug classes, such as anticoagulants, antidiabetic and psychotropic medications. This review examines the primary age-related physiological changes in geriatrics and their impact on the pharmacokinetics and pharmacodynamics of medications.

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来源期刊
CiteScore
8.80
自引率
4.40%
发文量
86
审稿时长
6-12 weeks
期刊介绍: Clinical Pharmacokinetics promotes the continuing development of clinical pharmacokinetics and pharmacodynamics for the improvement of drug therapy, and for furthering postgraduate education in clinical pharmacology and therapeutics. Pharmacokinetics, the study of drug disposition in the body, is an integral part of drug development and rational use. Knowledge and application of pharmacokinetic principles leads to accelerated drug development, cost effective drug use and a reduced frequency of adverse effects and drug interactions.
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