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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 5/2016

01.07.2016 | Originalien

DEL-FINE: a new tool for assessing the delirogenic properties of drugs of relevance for European pharmacotherapy

verfasst von: Birgit Böhmdorfer, Sonja Rohleder, Martin Wawruch, T.J.M. van der Cammen, Thomas Frühwald, Christian Jagsch, Susanne Melitta Maria Janowitz, Marietta Nagano, Mirko Petrovic, Ulrike Sommeregger, Bernhard Iglseder

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 5/2016

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Abstract

This article presents a list of potentially delirogenic properties of drugs that are currently of relevance to drug therapy in Europe, which was created through a Delphi process including experts from professions relevant to diagnosis and treatment of delirium. The Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5) defines delirium as a disturbance in attention, awareness and cognition that develops over a short period of time and fluctuates. Possible causes of delirium are manifold: usually delirium is considered to develop in a multifactorial way, caused by inalterable parameters, such as advanced age and pre-existing cognitive impairment and precipitated by modifiable parameters, such as the use of certain drugs or substance withdrawal. Delirium is a serious condition with a pronounced impact on morbidity, mortality and costs to the healthcare system. Circumstances and drugs that might precipitate or worsen delirium should therefore be avoided whenever possible. A list of drugs that might have a detrimental influence on the emergence and duration of delirium has been created using the terms “delirogenity” and “delirogenic” to describe the potential of a drug or withdrawal to cause or worsen delirium. The results are novel and noteworthy, as their focus is on substances relevant to European pharmacotherapy. Furthermore, they represent a methodical consensus from a group of experts of a wide variety of professions relevant to the prevention, diagnosis and treatment of delirium, such as nursing, pharmacy, pharmacology, surgical and internal medicine, neurology, psychiatry, intensive care and medicine, with working, teaching and scientific experience in several European countries practicing both in primary and secondary care.
Literatur
1.
Zurück zum Zitat American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Arlington, VA American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. Arlington, VA
2.
Zurück zum Zitat Bishara D, Harwood D (2014) Safe prescribing of physical health medication in patients with dementia. Int J Geriatr Psychiatry 29(12):1230–1241CrossRefPubMed Bishara D, Harwood D (2014) Safe prescribing of physical health medication in patients with dementia. Int J Geriatr Psychiatry 29(12):1230–1241CrossRefPubMed
3.
Zurück zum Zitat Boustani MA, Campbell NL, Munger S, Maidment I, Fox GC (2008) Impact on anticholinergics on the aging brain: a review and practical application. Aging Health 4(3):311–320CrossRef Boustani MA, Campbell NL, Munger S, Maidment I, Fox GC (2008) Impact on anticholinergics on the aging brain: a review and practical application. Aging Health 4(3):311–320CrossRef
4.
Zurück zum Zitat Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR (2006) The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol 46:1481–1486CrossRefPubMed Carnahan RM, Lund BC, Perry PJ, Pollock BG, Culp KR (2006) The Anticholinergic Drug Scale as a measure of drug-related anticholinergic burden: associations with serum anticholinergic activity. J Clin Pharmacol 46:1481–1486CrossRefPubMed
5.
Zurück zum Zitat Cherubini A, Del Signore S, Ouslander J, Semla T, Michel JP (2010) Fighting against age discrimination in clinical trials. J Am Geriatr Soc 58:1791–1796CrossRefPubMed Cherubini A, Del Signore S, Ouslander J, Semla T, Michel JP (2010) Fighting against age discrimination in clinical trials. J Am Geriatr Soc 58:1791–1796CrossRefPubMed
6.
Zurück zum Zitat Chew ML, Benoit HM, Pollock BG, Lehman ME, Greenspan A, Ramy AM et al (2008) Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc 56(7):1333–1341CrossRefPubMed Chew ML, Benoit HM, Pollock BG, Lehman ME, Greenspan A, Ramy AM et al (2008) Anticholinergic activity of 107 medications commonly used by older adults. J Am Geriatr Soc 56(7):1333–1341CrossRefPubMed
7.
Zurück zum Zitat Clinical Pharmacology (2012) “Drugs believed to cause or prolong delirium or confusional states.” and “Drugs having an adverse reaction of delirium” Gold Standard, Inc. Clinical Pharmacology. http://www.clinicalpharmacology.com. Accessed 29 Nov 2012 Clinical Pharmacology (2012) “Drugs believed to cause or prolong delirium or confusional states.” and “Drugs having an adverse reaction of delirium” Gold Standard, Inc. Clinical Pharmacology. http://​www.​clinicalpharmaco​logy.​com. Accessed 29 Nov 2012
8.
Zurück zum Zitat Garfinkel D, Zur-Gil S, Ben-Israel J (2007) The war against polypharmacy: a new cost-effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J 9(6):430–434PubMed Garfinkel D, Zur-Gil S, Ben-Israel J (2007) The war against polypharmacy: a new cost-effective geriatric-palliative approach for improving drug therapy in disabled elderly people. Isr Med Assoc J 9(6):430–434PubMed
9.
Zurück zum Zitat Gerretsen P, Pollock PG (2013) Cognitive risks of anticholinergics in the elderly. Aging Health 9(2):159–166CrossRef Gerretsen P, Pollock PG (2013) Cognitive risks of anticholinergics in the elderly. Aging Health 9(2):159–166CrossRef
10.
Zurück zum Zitat Gogol M, Hartmann H, Wustmann S, Simma A (2014) Influence of central nervous system-acting drugs on results of cognitive testing in geriatric inpatients. Z Gerontol Geriatr 47(4):279–284CrossRefPubMed Gogol M, Hartmann H, Wustmann S, Simma A (2014) Influence of central nervous system-acting drugs on results of cognitive testing in geriatric inpatients. Z Gerontol Geriatr 47(4):279–284CrossRefPubMed
11.
Zurück zum Zitat Häder M (2009) Delphi-Befragungen. Ein Arbeitsbuch, 2nd edn. VS Verlag für Sozialwissenschaften/GWV Fachverlage GmbH, WiesbadenCrossRef Häder M (2009) Delphi-Befragungen. Ein Arbeitsbuch, 2nd edn. VS Verlag für Sozialwissenschaften/GWV Fachverlage GmbH, WiesbadenCrossRef
12.
Zurück zum Zitat Han L, McCusker J, Cole M, Abrahamovicz M, Primeau F, Elie M (2001) Use of medications with anticholinergic effects predicts clinical severity of delirium symptoms in older medical patients. Arch Intern Med 161(8):1099–1105CrossRefPubMed Han L, McCusker J, Cole M, Abrahamovicz M, Primeau F, Elie M (2001) Use of medications with anticholinergic effects predicts clinical severity of delirium symptoms in older medical patients. Arch Intern Med 161(8):1099–1105CrossRefPubMed
13.
Zurück zum Zitat Han L, Agostini JV, Allore HG (2008) Cumulative anticholinergic exposure is associated with poor memory and executive function in older men. J Am Geriatr Soc 56(12):2203–2210CrossRefPubMedPubMedCentral Han L, Agostini JV, Allore HG (2008) Cumulative anticholinergic exposure is associated with poor memory and executive function in older men. J Am Geriatr Soc 56(12):2203–2210CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Holt S, Schmiedl S, Thürman PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 170(31–32):543–551 Holt S, Schmiedl S, Thürman PA (2010) Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int 170(31–32):543–551
17.
Zurück zum Zitat Inouye SK, Westendorp RG, Saczynski JS (2014) Derium in elderly people. Lancet 383(9920):911–922CrossRefPubMed Inouye SK, Westendorp RG, Saczynski JS (2014) Derium in elderly people. Lancet 383(9920):911–922CrossRefPubMed
18.
Zurück zum Zitat Irving K, Fick D, Foreman M (2006) Delirium: a new appraisal of an old problem. J Older People Nurs 1:106–112CrossRef Irving K, Fick D, Foreman M (2006) Delirium: a new appraisal of an old problem. J Older People Nurs 1:106–112CrossRef
19.
Zurück zum Zitat Kuhn-Thiel A, Weiß C, Wehlin M (2014) Consensus validation of the FORTA (Fit for The Aged) List: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31:131–140CrossRefPubMed Kuhn-Thiel A, Weiß C, Wehlin M (2014) Consensus validation of the FORTA (Fit for The Aged) List: a clinical tool for increasing the appropriateness of pharmacotherapy in the elderly. Drugs Aging 31:131–140CrossRefPubMed
20.
Zurück zum Zitat Lertxundi U, Domingo-Echaburu S, Hernandez R, Peral J, Medrano J (2013) Expert-based drug lists to measure anticholinergic burden: similar names, different results. Psychogeriatrics 13(1):17–24CrossRefPubMed Lertxundi U, Domingo-Echaburu S, Hernandez R, Peral J, Medrano J (2013) Expert-based drug lists to measure anticholinergic burden: similar names, different results. Psychogeriatrics 13(1):17–24CrossRefPubMed
21.
Zurück zum Zitat Maldonado JR (2008) Pathoetiological model of delirium: a comprehensive understanding of the neurobiology of delirium and an evidence-based approach to prevention and treatment. Crit Care Clin 24:789–856CrossRefPubMed Maldonado JR (2008) Pathoetiological model of delirium: a comprehensive understanding of the neurobiology of delirium and an evidence-based approach to prevention and treatment. Crit Care Clin 24:789–856CrossRefPubMed
22.
Zurück zum Zitat Mann E, Böhmdorfer B, Frühwald T, Roller-Wirnsberger RE, Dovjak P, Dückelmann-Hofer C et al (2012) Potentially inappropriate medication in geriatric patiens: the Austrian consensus panel list. Wien Klin Wochenschr 124(5–6):160–169CrossRefPubMed Mann E, Böhmdorfer B, Frühwald T, Roller-Wirnsberger RE, Dovjak P, Dückelmann-Hofer C et al (2012) Potentially inappropriate medication in geriatric patiens: the Austrian consensus panel list. Wien Klin Wochenschr 124(5–6):160–169CrossRefPubMed
23.
Zurück zum Zitat Misak C (2005) ICU psychosis and patient autonomy: some thoughts from the inside. J Med Philos 30:411–430CrossRefPubMed Misak C (2005) ICU psychosis and patient autonomy: some thoughts from the inside. J Med Philos 30:411–430CrossRefPubMed
24.
Zurück zum Zitat Moore AR, O’Keeffee ST (1999) Drug-induced cognitive impairment in the elderly. Drugs Aging 15(1):15–28CrossRefPubMed Moore AR, O’Keeffee ST (1999) Drug-induced cognitive impairment in the elderly. Drugs Aging 15(1):15–28CrossRefPubMed
27.
Zurück zum Zitat Rudd KM, Reahl CL, Bond CA, Abbruscato TJ, Stenhouse AC (2005) Methods for assessing drug-related anticholinergic activity. Pharmacotherapy 25(11):1592–1601CrossRefPubMed Rudd KM, Reahl CL, Bond CA, Abbruscato TJ, Stenhouse AC (2005) Methods for assessing drug-related anticholinergic activity. Pharmacotherapy 25(11):1592–1601CrossRefPubMed
28.
Zurück zum Zitat Rudolph JL, Salow MJ, Angelini MC, mcglinchey RE (2008) The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 168(5):508–513CrossRefPubMed Rudolph JL, Salow MJ, Angelini MC, mcglinchey RE (2008) The anticholinergic risk scale and anticholinergic adverse effects in older persons. Arch Intern Med 168(5):508–513CrossRefPubMed
29.
Zurück zum Zitat Salahudeen MS, Hilmer SN, Nishtala PS (2015) Comparison of anticholinergic risk scales and associations with adverse health outcomes in older people. J Am Ger Soc 63:85–90CrossRef Salahudeen MS, Hilmer SN, Nishtala PS (2015) Comparison of anticholinergic risk scales and associations with adverse health outcomes in older people. J Am Ger Soc 63:85–90CrossRef
30.
Zurück zum Zitat Sanders RD, Maze M (2011) Contribution of sedative-hypnotic agents to delirium via modulation of the sleep pathway. Can J Anesth 58:149–156CrossRefPubMed Sanders RD, Maze M (2011) Contribution of sedative-hypnotic agents to delirium via modulation of the sleep pathway. Can J Anesth 58:149–156CrossRefPubMed
31.
Zurück zum Zitat The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults (2015) The American Geriatrics Society abstracted Clinical Practice Guideline for postoperative delirium in older adults. J Am Geriatr Soc 63:142–150CrossRef The American Geriatrics Society Expert Panel on Postoperative Delirium in Older Adults (2015) The American Geriatrics Society abstracted Clinical Practice Guideline for postoperative delirium in older adults. J Am Geriatr Soc 63:142–150CrossRef
32.
Zurück zum Zitat UptoDate® Wolters Kluwer (2012) “Substances possessing anticholinergic properties.” and “Drugs believed to cause or prolong delirium” or confusional states. In UpToDate® Wolters Kluwer Health, [database online]. http://www.uptodate.com. Accessed 26 Feb 2015 UptoDate® Wolters Kluwer (2012) “Substances possessing anticholinergic properties.” and “Drugs believed to cause or prolong delirium” or confusional states. In UpToDate® Wolters Kluwer Health, [database online]. http://​www.​uptodate.​com. Accessed 26 Feb 2015
33.
Zurück zum Zitat Wright RM, Roumani YF, Bourderau R, Newman AB, Ruby CM, Studenski SA et al (2009) Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study. J Am Geriatr Soc 57(2):243–250CrossRefPubMedPubMedCentral Wright RM, Roumani YF, Bourderau R, Newman AB, Ruby CM, Studenski SA et al (2009) Effect of central nervous system medication use on decline in cognition in community-dwelling older adults: findings from the Health, Aging And Body Composition Study. J Am Geriatr Soc 57(2):243–250CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M et al (2013) Sleep drives metabolite clearance from the adult brain. Science 324 (6156):373–377CrossRef Xie L, Kang H, Xu Q, Chen MJ, Liao Y, Thiyagarajan M et al (2013) Sleep drives metabolite clearance from the adult brain. Science 324 (6156):373–377CrossRef
Metadaten
Titel
DEL-FINE: a new tool for assessing the delirogenic properties of drugs of relevance for European pharmacotherapy
verfasst von
Birgit Böhmdorfer
Sonja Rohleder
Martin Wawruch
T.J.M. van der Cammen
Thomas Frühwald
Christian Jagsch
Susanne Melitta Maria Janowitz
Marietta Nagano
Mirko Petrovic
Ulrike Sommeregger
Bernhard Iglseder
Publikationsdatum
01.07.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 5/2016
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-015-0941-9

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