Проблемы эффективной фармакотерапии пациентов пожилого и старческого возраста
Проблемы эффективной фармакотерапии пациентов пожилого и старческого возраста
Король Л.А., Егорова С.Н., Кудлай Д.А., Краснюк И.И., Сологова С.С., Король В.А., Смолярчук Е.А., Мандрик М.А. Проблемы эффективной фармакотерапии пациентов пожилого и старческого возраста. Терапевтический архив. 2022;94(7):914–919.DOI: 10.26442/00403660.2022.07.201717
________________________________________________
Korol LA, Egorova SN, Kudlay DA, Krasnyuk II, Sologova SS, Korol VA, Smolyarchuk EA, Mandrik MA. Problems associated with effective pharmacotherapy of the elderly patients (geriatrics): A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(7):914–919. DOI: 10.26442/00403660.2022.07.201717
Проблемы эффективной фармакотерапии пациентов пожилого и старческого возраста
Король Л.А., Егорова С.Н., Кудлай Д.А., Краснюк И.И., Сологова С.С., Король В.А., Смолярчук Е.А., Мандрик М.А. Проблемы эффективной фармакотерапии пациентов пожилого и старческого возраста. Терапевтический архив. 2022;94(7):914–919.DOI: 10.26442/00403660.2022.07.201717
________________________________________________
Korol LA, Egorova SN, Kudlay DA, Krasnyuk II, Sologova SS, Korol VA, Smolyarchuk EA, Mandrik MA. Problems associated with effective pharmacotherapy of the elderly patients (geriatrics): A review. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(7):914–919. DOI: 10.26442/00403660.2022.07.201717
Обеспечение должного качественного уровня жизни пожилого населения, доля которого в мире постоянно возрастает благодаря снижению заболеваемости и уровня инвалидизации гериатрических пациентов, является одной из основных задач современной системы здравоохранения. Вместе с тем изменения, ассоциированные со старением организма, обусловливают необходимость не только применения новых подходов к коррекции фармакотерапии, но и использования специально подобранных лекарственных форм, как обеспечивающих соответствующий терапевтический эффект, так и максимально облегчающих их использование. В представленном обзоре рассмотрен ряд особенностей фармакотерапии пациентов старческого и пожилого возраста.
The world’s older population is growing dramatically. At the same time, ensuring an appropriate high standard of living for the elderly by reducing of morbidity and disability of geriatric patients is one of the main objectives of the modern healthcare system. However, changes associated with body aging necessitate application of novel approaches to the correction of pharmacotherapy and usage of specialized dosage forms. Such medicinal products provide both an appropriate therapeutic effect and facilitate their use. Presented review considers several features of pharmacotherapy of geriatric patients.
1. United Nations. Department of Economic and Social Affairs. World population ageing 2019. United Nations Publications, 2020.
2. Marcum Z, Gellad W. Medication adherence to multidrug regimens. Clin Geriatr Med. 2012;28(2):287-300. DOI:10.1016/j.cger.2012.01.008
3. Bartels S, Fortuna K, Naslund J. Serious Mental Disorders in Older Adults: Schizophrenia and Other Late-Life Psychoses. Aging Ment Health. 2017;241-80. DOI:10.1002/9781119133186.ch10
4. Lavan A, O’Grady J, Gallagher P. Appropriate prescribing in the elderly: Current perspectives. World J Pharmacol. 2015;4:193-209. DOI:10.5497/wjp.v4.i2.193
5. Поликлиническая терапия. 2-е изд. Под ред. Д.И. Давыдкина, Ю.В. Щукина. М.: ГЭОТАР-Медиа, 2020 [Poliklinicheskaya terapiya. 2-e izd. Pod red. DI Davydkina, YuV Shukina. Moscow: GEOTAR-Media, 2020 (in Russian)].
6. Леонова М.В., Алимова Э.Э. Клиническая фармакология в гериатрии. Клиническая геронтология. 2018;24(7-8):32-9 [Leonova MV, Alimova EE. Clinical pharmacology in geriatrics. Klinicheskaya gerontologiya. 2018;24(7-8):32-9 (in Russian)]. DOI:10.26347/1607-2499201807-08032-039
7. Общие принципы фармакотерапии у лиц пожилого и старческого возраста. Методические рекомендации. Под ред. О.Н. Ткачевой. М.: Прометей, 2019 [Obshchie printsipy farmakoterapii u lits pozhilogo i starcheskogo vozrasta. Metodicheskie rekomendatsii. Pod red. ON Tkachevoi. Moscow: Prometei, 2019 (in Russian)].
8. Хасанов А.Х., Бакиров Б.А., Давлетшин Р.А., и др. Влияние эндотелиальной дисфункции на гендерно-сосудистую и нейрокогнитивную гетерогенность при мультифокальном атеросклерозе у пожилых пациентов. Профилактическая медицина. 2019;22(4):129-37 [Khasanov AKh, Bakirov BA, Davletshin RA, et al. Impact of endothelial dysfunction on gender-specific vascular and neurocognitive heterogeneity in multifocal atherosclerosis in elderly patients. Profilakticheskaya medicina. 2019;22(4):129-37 (in Russian)]. DOI:10.17116/profmed201922041129
9. How P, Xiong G. Pharmacological Overview in Geriatrics: Pharmacodynamics, Pharmacokinetics, Laboratory Monitoring. Inpatient Geriatric Psychiatry. 2019:47-61.
DOI:10.1007/978-3-030-10401-6_3
10. Ronaldson P, Bauer B, El-Kattan A, et al. Highlights from the American Association of Pharmaceutical Scientists/International Transporter Consortium Joint Workshop on drug transporters in absorption, distribution, metabolism, and excretion: from the bench to the bedside–clinical pharmacology considerations. Clin Pharmacol Ther. 2016;100(5):419-22. DOI:10.1002/cpt.439
11. Газизов Р.М. Основы лекарственной терапии в пожилом и старческом возрасте. Практическая медицина. 2010;41:11-4 [Gazizov RM. Foundations of drug therapy in elderly and senile age. Prakticheskaya medicina. 2010;41:11-4 (in Russian)].
12. Herman R, Wilkinson G. Disposition of diazepam in young and elderly subjects after acute and chronic dosing. Br J Clin Pharmacol. 1996;42(2):147-55.
DOI:10.1046/j.1365-2125.1996.03642.x
13. Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol. 2003;38(8):843-53. DOI:10.1016/S0531-5565(03)00133-5
14. Turnheim K. Drug dosage in the elderly. Drugs Aging. 1998;13(5):357‑79. DOI:10.2165/00002512-199813050-00003
15. Wynn G, Oesterheld J, Cozza L, Armstrong S. Clinical Manual of Drug Interaction Principles for Medical Practice. American Psychiatric Pub, 2009.
16. Wauthier V, Verbeeck R, Buc Calderon P. The effect of ageing on cytochrome p450 enzymes: consequences for drug biotransformation in the elderly. Curr Med Chem. 2007;14(7):745-57. DOI:10.2174/092986707780090981
17. Pollock B, Forsyth C, Bies R. The critical role of clinical pharmacology in geriatric psychopharmacology. Clin Pharmacol Ther. 2009;85(1):89‑93. DOI:10.1038/clpt.2008.229
18. Aymanns C, Keller F, Maus S, et al. Review on pharmacokinetics and pharmacodynamics and the aging kidney. Clin J Am Soc Nephrol. 2010;5(2):314-27. DOI:10.2215/CJN.03960609
19. Антощенко П.А. Особенности изменения скорости клубочковой фильтрации у лиц старшего возраста с физиологическим и патологическим типом старения. Международный студенческий научный вестник. 2016;6:15 [Antoshchenko PA. Osobennosti izmeneniia skorosti klubochkovoi fil'tratsii u lits starshego vozrasta s fiziologicheskim i patologicheskim tipom stareniia. Mezhdunarodnyi studencheskii nauchnyi vestnik. 2016;6:15 (in Russian)].
20. O’Sullivan E, Hughes J, Ferenbach D. Renal aging: causes and consequences. J Am Soc Nephrol. 2017;28(2):407-20. DOI:10.1681/ASN.2015121308
21. Chen R, Zou S, Wang L, et al. Population pharmacokinetics of digoxin in elderly patients. Eur J Drug Metab Pharmacokinet. 2013;38(2):115-21. DOI:10.1007/s13318-012-0107-8
22. Ingrasciotta Y, Sultana J, Giorgianni F, et al. Association of individual non-steroidal anti-inflammatory drugs and chronic kidney disease: a population-based case control study. PLoS One. 2015;10(4):e0122899. DOI:10.1371/journal.pone.0122899
23. Mukker J, Singh R, Derendorf H. Pharmacokinetic and pharmacodynamics considerations in elderly population. Developing Drug Products in an Aging Society. 2016;139-51. DOI:10.1007/978-3-319-43099-7_10
24. Rochon P, Gurwitz J. The prescribing cascade revisited. Lancet. 2017;389(10081):1778-80. DOI:10.1016/S0140-6736(17)31188-1
25. Salive M. Multimorbidity in older adults. Epidemiol Rev. 2013;35(1):75‑83. DOI:10.1093/epirev/mxs009
26. Roughead E, Vitry A, Caughey G, Gilbert A. Multimorbidity, care complexity and prescribing for the elderly. Aging Health. 2011;7(5):695‑705. DOI:10.2217/ahe.11.64
27. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey G. What is polypharmacy? A systematic review of definitions. BMC geriatrics. 2017;17(1):230. DOI:10.1186/s12877-017-0621-2
28. Сычев Д.А., Отделенов В.А., Краснова Н.М., Ильина Е.С. Полипрагмазия: взгляд клинического фармаколога. Терапевтический архив. 2016;88(12):94-102 [Sychev DA, Otdelenov VA, Krasnova NM, Il'ina ES. Polypragmasy: A clinical pharmacologist's view. Terapevticheskii Arkhiv (Ter. Arkh.). 2016;88(12):94-102 (in Russian)]. DOI:10.17116/terarkh2016881294-102
29. Naples J, Marcum Z, Perera S, et al. Concordance Between Anticholinergic Burden Scales. J Am Geriatr Soc. 2015;63(10):2120-4. DOI:10.1111/jgs.13647
30. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227-46. DOI:10.1111/jgs.13702
31. Kumar R, Neethu B. Fast Dissolving Tablets: Better Option for Pediatrics and Geriatrics. Journal of Drug Delivery and Therapeutics. 2019;9(4‑A):831-4. DOI:10.22270/jddt.v9i4-A.3689
32. Sharma M, Leel M. A Review on Dispersible Tablets: A Novel Drug Delivery System for Pedietrics and Geriatrics. Int J Drug Dev Res. 2022;14(1). DOI:10.36648/0975-9344.22.1.171
33. Khan M, Roberts S. Challenges and innovations of drug delivery in older age. Adv Drug Deliv Rev. 2018;135:3-38. DOI:10.1016/j.addr.2018.09.003
34. Консон К., Фролова Е.В., Костюкович О.М. Мультидисциплинарный подход в гериатрии. Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2018;10:4 [Konson K, Frolova EV, Kostyukovich OM. Multidisciplinary approach in geriatric. Vestnik Severo-Zapadnogo gosudarstvennogo medicinskogo universiteta im. I.I. Mechnikova. 2018;10:4 (in Russian)]. DOI:10.17816/mechnikov201810449-54
35. Shatalov D, Kedik S, Panov A, et al. Antimicrobial activity of branched oligo(hexamethyleneguanidine) hydrochloride on oral pathogens. Russian Open Medical Journal. 2018;7(3):309. DOI:10.15275/rusomj.2018.0309
36. Michael F, Parisa A, Timothy C, David T. Use of Medicine by the elderly. The role of pharmacy in promoting adherence. International Pharmaceutical Federation, 2018.
________________________________________________
1. United Nations. Department of Economic and Social Affairs. World population ageing 2019. United Nations Publications, 2020.
2. Marcum Z, Gellad W. Medication adherence to multidrug regimens. Clin Geriatr Med. 2012;28(2):287-300. DOI:10.1016/j.cger.2012.01.008
3. Bartels S, Fortuna K, Naslund J. Serious Mental Disorders in Older Adults: Schizophrenia and Other Late-Life Psychoses. Aging Ment Health. 2017;241-80. DOI:10.1002/9781119133186.ch10
4. Lavan A, O’Grady J, Gallagher P. Appropriate prescribing in the elderly: Current perspectives. World J Pharmacol. 2015;4:193-209. DOI:10.5497/wjp.v4.i2.193
5. Poliklinicheskaya terapiya. 2-e izd. Pod red. DI Davydkina, YuV Shukina. Moscow: GEOTAR-Media, 2020 (in Russian).
6. Leonova MV, Alimova EE. Clinical pharmacology in geriatrics. Klinicheskaya gerontologiya. 2018;24(7-8):32-9 (in Russian). DOI:10.26347/1607-2499201807-08032-039
7. Obshchie printsipy farmakoterapii u lits pozhilogo i starcheskogo vozrasta. Metodicheskie rekomendatsii. Pod red. ON Tkachevoi. Moscow: Prometei, 2019 (in Russian).
8. Khasanov AKh, Bakirov BA, Davletshin RA, et al. Impact of endothelial dysfunction on gender-specific vascular and neurocognitive heterogeneity in multifocal atherosclerosis in elderly patients. Profilakticheskaya medicina. 2019;22(4):129-37 (in Russian).
DOI:10.17116/profmed201922041129
9. How P, Xiong G. Pharmacological Overview in Geriatrics: Pharmacodynamics, Pharmacokinetics, Laboratory Monitoring. Inpatient Geriatric Psychiatry. 2019:47-61.
DOI:10.1007/978-3-030-10401-6_3
10. Ronaldson P, Bauer B, El-Kattan A, et al. Highlights from the American Association of Pharmaceutical Scientists/International Transporter Consortium Joint Workshop on drug transporters in absorption, distribution, metabolism, and excretion: from the bench to the bedside–clinical pharmacology considerations. Clin Pharmacol Ther. 2016;100(5):419-22. DOI:10.1002/cpt.439
11. Gazizov RM. Foundations of drug therapy in elderly and senile age. Prakticheskaya medicina. 2010;41:11-4 (in Russian).
12. Herman R, Wilkinson G. Disposition of diazepam in young and elderly subjects after acute and chronic dosing. Br J Clin Pharmacol. 1996;42(2):147-55.
DOI:10.1046/j.1365-2125.1996.03642.x
13. Turnheim K. When drug therapy gets old: pharmacokinetics and pharmacodynamics in the elderly. Exp Gerontol. 2003;38(8):843-53. DOI:10.1016/S0531-5565(03)00133-5
14. Turnheim K. Drug dosage in the elderly. Drugs Aging. 1998;13(5):357‑79. DOI:10.2165/00002512-199813050-00003
15. Wynn G, Oesterheld J, Cozza L, Armstrong S. Clinical Manual of Drug Interaction Principles for Medical Practice. American Psychiatric Pub, 2009.
16. Wauthier V, Verbeeck R, Buc Calderon P. The effect of ageing on cytochrome p450 enzymes: consequences for drug biotransformation in the elderly. Curr Med Chem. 2007;14(7):745-57. DOI:10.2174/092986707780090981
17. Pollock B, Forsyth C, Bies R. The critical role of clinical pharmacology in geriatric psychopharmacology. Clin Pharmacol Ther. 2009;85(1):89‑93. DOI:10.1038/clpt.2008.229
18. Aymanns C, Keller F, Maus S, et al. Review on pharmacokinetics and pharmacodynamics and the aging kidney. Clin J Am Soc Nephrol. 2010;5(2):314-27. DOI:10.2215/CJN.03960609
19. Antoshchenko PA. Osobennosti izmeneniia skorosti klubochkovoi fil'tratsii u lits starshego vozrasta s fiziologicheskim i patologicheskim tipom stareniia. Mezhdunarodnyi studencheskii nauchnyi vestnik. 2016;6:15 (in Russian).
20. O’Sullivan E, Hughes J, Ferenbach D. Renal aging: causes and consequences. J Am Soc Nephrol. 2017;28(2):407-20. DOI:10.1681/ASN.2015121308
21. Chen R, Zou S, Wang L, et al. Population pharmacokinetics of digoxin in elderly patients. Eur J Drug Metab Pharmacokinet. 2013;38(2):115-21. DOI:10.1007/s13318-012-0107-8
22. Ingrasciotta Y, Sultana J, Giorgianni F, et al. Association of individual non-steroidal anti-inflammatory drugs and chronic kidney disease: a population-based case control study. PLoS One. 2015;10(4):e0122899. DOI:10.1371/journal.pone.0122899
23. Mukker J, Singh R, Derendorf H. Pharmacokinetic and pharmacodynamics considerations in elderly population. Developing Drug Products in an Aging Society. 2016;139-51. DOI:10.1007/978-3-319-43099-7_10
24. Rochon P, Gurwitz J. The prescribing cascade revisited. Lancet. 2017;389(10081):1778-80. DOI:10.1016/S0140-6736(17)31188-1
25. Salive M. Multimorbidity in older adults. Epidemiol Rev. 2013;35(1):75‑83. DOI:10.1093/epirev/mxs009
26. Roughead E, Vitry A, Caughey G, Gilbert A. Multimorbidity, care complexity and prescribing for the elderly. Aging Health. 2011;7(5):695‑705. DOI:10.2217/ahe.11.64
27. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey G. What is polypharmacy? A systematic review of definitions. BMC geriatrics. 2017;17(1):230. DOI:10.1186/s12877-017-0621-2
28. Sychev DA, Otdelenov VA, Krasnova NM, Il'ina ES. Polypragmasy: A clinical pharmacologist's view. Terapevticheskii Arkhiv (Ter. Arkh.). 2016;88(12):94-102 (in Russian). DOI:10.17116/terarkh2016881294-102
29. Naples J, Marcum Z, Perera S, et al. Concordance Between Anticholinergic Burden Scales. J Am Geriatr Soc. 2015;63(10):2120-4. DOI:10.1111/jgs.13647
30. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227-46. DOI:10.1111/jgs.13702
31. Kumar R, Neethu B. Fast Dissolving Tablets: Better Option for Pediatrics and Geriatrics. Journal of Drug Delivery and Therapeutics. 2019;9(4‑A):831-4. DOI:10.22270/jddt.v9i4-A.3689
32. Sharma M, Leel M. A Review on Dispersible Tablets: A Novel Drug Delivery System for Pedietrics and Geriatrics. Int J Drug Dev Res. 2022;14(1). DOI:10.36648/0975-9344.22.1.171
33. Khan M, Roberts S. Challenges and innovations of drug delivery in older age. Adv Drug Deliv Rev. 2018;135:3-38. DOI:10.1016/j.addr.2018.09.003
34. Konson K, Frolova EV, Kostyukovich OM. Multidisciplinary approach in geriatric. Vestnik Severo-Zapadnogo gosudarstvennogo medicinskogo universiteta im. I.I. Mechnikova. 2018;10:4 (in Russian). DOI:10.17816/mechnikov201810449-54
35. Shatalov D, Kedik S, Panov A, et al. Antimicrobial activity of branched oligo(hexamethyleneguanidine) hydrochloride on oral pathogens. Russian Open Medical Journal. 2018;7(3):309. DOI:10.15275/rusomj.2018.0309
36. Michael F, Parisa A, Timothy C, David T. Use of Medicine by the elderly. The role of pharmacy in promoting adherence. International Pharmaceutical Federation, 2018.
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия;
2 ФГБОУ ВО «Казанский государственный медицинский университет» Минздрава России, Казань, Россия
*mandrik_m_a@staff.sechenov.ru
________________________________________________
Liudmila A. Korol1, Svetlana N. Egorova2, Dmitry A. Kudlay1, Ivan I. Krasnyuk1, Susanna S. Sologova1, Viktoria A. Korol1, Elena A. Smolyarchuk1, Mark A. Mandrik*1
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;
2 Kazan State Medical University, Kazan, Russia
*mandrik_m_a@staff.sechenov.ru