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Medikamenteninteraktionen in der Geriatrie

Drug interactions in geriatric medicine

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Summary

Drug interactions are often seen in elder patients due to polymedication. They can lead to unwanted side effects attended with unspecific symptoms such as vertigo, lateropulsion, fatigue or confusion. This can result in a prescribing cascade. Interactions can take place on all pharmacodynamic and pharmacokinetic levels, whereas the CYP enzyme-dependent metabolism seems to play a key role. The incidence of drug interactions is quite high and clinical relevant interactions are also not uncommon. Especially drugs with a low therapeutic index are more likely to be the target of clinical relevant interactions. However, most of the drug interactions can be managed by dose-reduction or by replacing one of the possibly interacting drugs. An important point is to remember the possibility of drug interactions.

Zusammenfassung

Arzneimittelinteraktionen treten vor allem bei älteren Patienten aufgrund der Vielmedikation (Polypragmasie) auf und können zu unerwünschten Wirkungen führen. Diese können sich in unspezifischen Symptomen wie Schwindel, Fallneigung, Müdigkeit oder Verwirrtheitszuständen äußern und durch Fehleinschätzung eine Verschreibungskaskade auslösen. Medikamentenwechselwirkungen können auf allen Ebenen der Pharmakodynamik und Pharmakokinetik stattfinden, wobei vor allem der CYP-Enzym abhängige Metabolismus von besonderer Bedeutung ist. Arzneimittelinteraktionen treten häufig auf und auch klinisch relevante Interaktionen sind nicht selten und kommen auch vor allem bei Medikamenten mit einer geringen therapeutischen Breite vor. Diese sind zumeist durch eine Dosisreduktion oder einen Wechsel auf ein anderes Medikament beherrschbar. Aber auch bei unspezifischen Symptomen sollte eine Arzneimittelineraktion in Betracht gezogen werden.

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  1. Universitätsklinik für Klinische Pharmakologie, Medizinische Universität Wien, Wien, Austria

    Angela Storka & Johannes Pleiner

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  1. Angela Storka
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  2. Johannes Pleiner
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Correspondence to Johannes Pleiner.

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Storka, A., Pleiner, J. Medikamenteninteraktionen in der Geriatrie. Wien Med Wochenschr 159, 462–469 (2009). https://doi.org/10.1007/s10354-009-0708-2

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  • DOI: https://doi.org/10.1007/s10354-009-0708-2

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