老年医学常用抗炎药的毒性分析

Talal Alhouzani, Mohammad Saleem, S. Khadka, Saleh Musaed Mohammed Al-Subari, D. Shrestha, Imamah Anwar Butt
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引用次数: 2

摘要

抗炎药是老年医学中最常用的药物之一。与年轻患者相比,老年患者通常会遇到疼痛和炎症问题,并且更容易受到药物毒性的影响。在这篇综述中,我们的目的是找出药物的毒性特征和老年护理的药物治疗注意事项。老年人最常患的疾病是骨关节炎(OA)、强直性脊柱炎、癌和其他需要抗炎药物的退行性疾病。非甾体类抗炎药(NSAIDs)和皮质类固醇是治疗老年炎症的常用药物。由于非处方药(OTC)的可用性,非甾体抗炎药大多被使用和自我治疗。由于老年患者机体生理机能的改变,药物的药代动力学发生改变,药效学也受到影响,因此即使在正常剂量下也会产生毒性。视乎药物的性质;发生胃肠道、肾脏和心血管毒性。由于这个原因,在这类人群中进行药物治疗时应格外小心。合并症和多重用药的存在将使药物治疗复杂化。这些药物应在最短的时间内以最低的有效剂量使用,并仔细监测毒性。在这类人群的药物治疗实践中,必须仔细评估药物的有益和潜在风险。
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Toxicity Profiles of Commonly Used Anti-Inflammatory Drugs in Geriatrics
Anti-inflammatory drugs are among the mostly used drugs in geriatrics. Geriatrics usually encounter problems of pain and inflammation and are more vulnerable to the toxicity of drugs as compared to young patients. In this review, we aimed to find out the toxic profile of drugs and the pharmacotherapy considerations for geriatric care. The diseases geriatrics mostly suffered from are osteoarthritis (OA), ankylosing spondylitis, carcinoma, and other degenerative disorders that require anti-inflammatory medicines. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids are mostly used agents for the treatment of inflammation in geriatrics. Due to the over the counter (OTC) availability, NSAIDs are mostly used and being self-medicated as well. As the pharmacokinetics of drugs get altered due to alteration in body physiology in geriatrics, the pharmacodynamics also gets affected, and hence toxicity ensues even with normal dose. Depending upon the nature of the drugs; gastrointestinal, renal, and cardiovascular toxicities occur. Due to this reason, utmost care should be taken for pharmacotherapy practice in such population. The presence of comorbidity and poly-pharmacy will complicate drug therapy. The drugs should be used for the shortest duration possible at the lowest effective dose, and with careful surveillance to monitor toxicities. The careful evaluation of the beneficial and potential risks of the agents must be considered for pharmacotherapy practice in such populations.
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