노인 입원환자에서 발생한 약물유해반응의 특성
Adverse Drug Reactions in Elderly Inpatients: Comparison with Younger Patients
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background: There have been few reports on the characteristics of adverse drug reactions (ADRs) in elderly patients among the Korean population. Objective: To investigate the characteristics of ADRs in elderly patients compared with those in younger ones. Method: ADRs were collected from a spontaneous reporting system at our university hospital in 2008. Characteristics including underlying diseases, duration of hospitalization,clinical manifestations, culprit drugs and number of concomitant medications were compared between the young (＜65 years) and elderly (≥65 years) groups. Result: A total of 528 ADRs occurred in 513 patients, and 120 ADRs (22.7%) occurred in 116 elderly patients. Their mean age was 71.6 years. Antibiotics (45.8%) were the most common culprit drugs. The prevalence of ADRs due to cardiovascular drugs was significantly higher in the elderly group (9.2%) than in the young group (2.9%,P=0.003). The most prevalent clinical types were skin manifestations (40.5%), gastrointestinal abnormalities (28.4%)and systemic reactions (23.5%) in both groups. Renal function abnormalities were significantly more prevalent in the elderly group (4.2%) than in the young group (0.5%,P=0.008). The mean number of concomitant medications was significantly higher in the elderly group (6.5±4.6) than in the young group (1.9±3.9). Conclusion: For the early detection of ADRs in elderly patients, close monitoring of cardiovascular drug use and renal function are recommended.
Abstract
Background: There have been few reports on the characteristics of adverse drug reactions (ADRs) in elderly patients among the Korean population. Objective: To investigate the characteristics of ADRs in elderly patients compared with those in younger ones. Method: ADRs were collected from a spontaneous reporting system at our university hospital in 2008. Characteristics including underlying diseases, duration of hospitalization,clinical manifestations, culprit drugs and number of concomitant medications were compared between the young (＜65 years) and elderly (≥65 years) groups. Result: A total of 528 ADRs occurred in 513 patients, and 120 ADRs (22.7%) occurred in 116 elderly patients. Their mean age was 71.6 years. Antibiotics (45.8%) were the most common culprit drugs. The prevalence of ADRs due to cardiovascular drugs was significantly higher in the elderly group (9.2%) than in the young group (2.9%,P=0.003). The most prevalent clinical types were skin manifestations (40.5%), gastrointestinal abnormalities (28.4%)and systemic reactions (23.5%) in both groups. Renal function abnormalities were significantly more prevalent in the elderly group (4.2%) than in the young group (0.5%,P=0.008). The mean number of concomitant medications was significantly higher in the elderly group (6.5±4.6) than in the young group (1.9±3.9). Conclusion: For the early detection of ADRs in elderly patients, close monitoring of cardiovascular drug use and renal function are recommended.
참고문헌 (15)
- Drug use pattern and evaluation for appropriateness in geriatric patients, "Oh J", Research report of Korean Food & Drug Administration, 16~83, pp.04142기본사858-2 (2004)
- Korea Food and Drug Administration (KFDA), "Provision of Safety Information Management Regulation of Drugs", pp.115~ (2009), KFDA Public Notification No
- Bressler R, "Principles of drug therapy for the elderly patient", Mayo Clin Proc, 78, pp.1564~77 (2003)
- Wawruch M, "Adverse drug reactions related to hospital admission in Slovak elderly patients", Arch Gerontol Geriatr, 48, pp.186~90 (2009)
- Caamano F, "Socio-demographic factors related to the prevalence of adverse drug reaction at hospital admission in an elderly population", Arch Gerontol Geriatr, 40, pp.45~52 (2005)
- Onder G, "Della Vedova C, Bernabei R, et al. Adverse drug reactions as cause of hospital admissions: results from the Italian Group of Pharmacoepidemiology in the Elderly (GIFA)", J Am Geriatr Soc, 50, pp.1962~8 (2002)
- Corsonello A, "Carbonin P, Antonelli Incalzi R. Concealed renal insufficiency and adverse drug reactions in elderly hospitalized patients", Arch Intern Med, 165, pp.790~5 (2005)
- 김형숙, "노인의료센터 입원환자의 약물유해반응 현황 및 위험인자 분석", 병원약사회지, 25(4), pp.1~10 (2008), 한국병원약사회
- Edwards IR, "Adverse drug reactions: definitions, diagnosis, and management", Lancet, 356, pp.1255~9 (2000)
- Lampela P, "Adverse drug effects in elderly people - a disparity between clinical examination and adverse effects self-reported by the patient", Eur J Clin Pharmacol, 63, pp.509~15 (2007)
- Routledge PA, "Adverse drug reactions in elderly patients", Brit J Clin Pharmacol, 57, pp.121~6 (2004)
- Olivier P, "Hospitalizations because of adverse drug reactions in elderly patients admitted through the emergency department: a prospective survey", Drugs Aging, 26, pp.475~82 (2009)
- Veehof LJ, "Adverse drug reactions and polypharmacy in the elderly in general practice", Eur J Clin Pharmacol, 55, pp.533~6 (1999)
- Pit SW, "Medication review: patient selection and general practitioner's report of drug-related problems and actions taken in elderly Australians", J Am Geriatr Soc, 55, pp.927~34 (2007)
- Cresswell KM, "Adverse drug events in the elderly", Br Med Bull, 83, pp.259~74 (2007)