вплив старіння на реакцію на ліки
Class | Drug | Action | Effect of Aging |
|---|---|---|---|
Analgesics | Morphine | Acute analgesic effect | ↑ |
Pentazocine | Analgesic effect | ↑ | |
Anticoagulants | Heparin | PTT (partial thromboplastin time) | ↔ |
Warfarin | PT/INR (prothrombin time/international normalized ratio) | ↑ | |
Bronchodilators | Albuterol | Bronchodilation | ↓ |
Ipratropium | Bronchodilation | ↔ | |
Cardiovascular drugs | Angiotensin II receptor blockers | Decreased blood pressure | ↑ |
Diltiazem | Acute antihypertensive effect | ↑ | |
Enalapril | Acute antihypertensive effect | ↑ | |
Felodipine | Antihypertensive effect | ↑ | |
Isoproterenol | Increased heart rate | ↓ | |
Increased ejection fraction | ↓ | ||
Venodilation | ↓ | ||
Nitroglycerin | Venodilation | ↔ | |
Norepinephrine | Acute vasoconstriction | ↔ | |
Phenylephrine | Acute venoconstriction | ↔ | |
Acute hypertensive effect | ↔ | ||
Prazosin | Acute antihypertensive effect | ↔ | |
Propranolol (and other beta-blockers) | Decreased heart rate | ↓ | |
Verapamil | Acute antihypertensive effect, cardiac conduction effects | ↑ | |
Diuretics | Bumetanide | Increased urine flow and sodium excretion | ↓ |
Furosemide | Latency and size of peak diuretic response | ↓ | |
Oral hypoglycemics | Glyburide* | Chronic hypoglycemic effect | ↑ |
Psychoactive drugs | Diazepam | Sedation | ↑ |
Diphenhydramine | Psychomotor dysfunction | ↑ | |
Haloperidol | Acute sedation | ↑ | |
Midazolam | Electroencephalogram (EEG) activity | ↑ | |
Sedation | ↑ | ||
Temazepam | Postural sway | ↑ | |
Psychomotor effect | ↑ | ||
Sedation | ↑ | ||
Thiopental | Anesthesia | ↔ | |
Triazolam | Sedation | ↑ | |
Others | Atropine | Impaired gastric emptying | ↔ |
Levodopa | Adverse effects | ↑ | |
Metoclopramide | Sedation | ↔ | |
↔ = unchanged; ↑ = increased; ↓ = decreased. * Older adults are particularly susceptible to the hypoglycemic action of glucose-lowering drugs. Hypoglycemia may be difficult to recognize in older adults. | |||
Adapted and updated from Cusack BJ, Vestal RE: Clinical pharmacology: Special considerations in the elderly. In Practice of Geriatric Medicine, edited by E Calkins, PJ Davis, and AB Ford. Philadelphia, WB Saunders Company, 1986, pp. 115–136; used with permission. | |||