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DOI: 10.1055/s-0031-1276844
Arzneimittelinteraktionen
Drug InteractionsPublication History
Publication Date:
01 July 2011 (online)
![](https://www.thieme-connect.de/media/palliativmedizin/201104/lookinside/thumbnails/10.1055-s-0031-1276844-1.jpg)
Zusammenfassung
Die Kombination verschiedener Medikamente gehört zum Alltag in der palliativmedizinischen Arzneimitteltherapie. Mit jeder Substanz steigt das Risiko von Arzneimittelinteraktionen, die die Therapiesicherheit und den Therapieerfolg erheblich beeinflussen können. Patientenindividuelle Faktoren spielen ebenso eine Rolle wie unterschiedliche zeitliche Zusammenhänge. Kenntnisse über pharmakokinetische und pharmakodynamische Eigenschaften verschiedener Substanzen sind zur Abschätzung des Interaktionspotenzials oftmals hilfreich. Nicht jede theoretische Interaktion hat jedoch Relevanz für die klinische Praxis. Wichtig ist ein grundsätzliches Bewusstsein für Wechselwirkungen, um die Arzneimitteltherapie entsprechend planen oder auf neu aufgetretene Symptome adäquat reagieren zu können.
Abstract
In palliative medicine, it is daily routine to combine various drugs. The risk of drug interactions which can affect drug safety and treatment success rises with every additional drug. Individual patient factors play a similar role as do different time contexts. Knowledge about pharmacokinetic and pharmacodynamic characteristics of various substances is helpful to estimate the risk of interactions. Not every theoretical interaction is relevant for clinical practice. It is important to have a basic awareness for interactions in order to plan drug therapy appropriately and to be able to react adequately to new symptoms.
Literatur
- 1 Juurlink D N, Mamdani M, Kopp A et al. Drug-Drug interactions among elderly patients hospitalized for drug toxicity. JAMA. 2003; 289 1652-1658
- 2 Krahenbuhl-Melcher A, Schlienger R, Lampert M et al. Drug-related problems in hospitals: A review of the recent literature. Drug Saf. 2007; 30 379-407
- 3 Corsonello A, Pedone C, Corica F et al. Polypharmacy in elderly patients at discharge from the acute care hospital. Ther Clin Risk Manag. 2007; 3 197-203
- 4 Koh Y, Kutty F B, Li S C. Drug-related problems in hospitalized patients on polypharmacy: The influence of age and gender. Ther Clin Risk Manag. 2005; 1 39-48
- 5 Nixdorff N, Hustey F M, Brady A K et al. Potentially inappropriate medications and adverse drug effects in elders in the ED. Am J Emerg Med. 2008; 26 697-700
- 6 Nauck F, Ostgathe C, Klaschik E et al. Drugs in palliative care: results from a representative survey in Germany. Palliat Med. 2004; 18 100-107
- 7 Gärtner J, Ruberg K, Schlesing G. Drug interactions in palliative care. Palliat Med. 2011; 12 (in press)
- 8 Regnard C, Hunter A. Increasing prescriber awareness of drug interactions in palliative care. J Pain Symptom Manage. 2005; 29 219-221
- 9 Oesterheld J. GeneMedRX.. Genelex; 2011
- 10 Gerdemann A, Griese N. Interaktionscheck in der Apotheke.. 1. Aufl. Eschborn: Govi Verlag; 2010
- 11 Carnahan R M, Lund B C, Perry P J et al. The concurrent use of anticholinergics and cholinesterase inhibitors: rare event or common practice?. J Am Geriatr Soc. 2004; 52 2082-2087
- 12 Punyawudho B, Cloyd J C, Leppik I E et al. Characterization of the time course of carbamazepine deinduction by an enzyme turnover model. Clin Pharmacokinet. 2009; 48 313-320
- 13 White C, McCann M A, Jackson N. First do no harm … Terminal restlessness or drug-induced delirium. J Palliat Med. 2007; 10 345-351
- 14 Benkert O, Hippius H. Kompendium der Psychiatrischen Pharmakotherapie.. 7. Aufl. Heidelberg: Springer; 2009
- 15 Schuurkes J AJ, Helsen L FM, Ghoos E CR et al. Stimulation of gastroduodenal motor activity: Dopaminergic and cholinergic modulation. Drug Develop Res. 1986; 8 233-241
- 16 Magee C L. The use of herbal and other dietary supplements and the potential for drug interactions in palliative care. Palliat Med. 2007; 21 547-548
- 17 Arnoldi J, Repking N. Olanzapine-induced parkinsonism associated with smoking cessation. Am J Health Syst Pharm. 2011; 68 399-401
- 18 Izzo A A. Herb-drug interactions: an overview of the clinical evidence. Fundam Clin Pharmacol. 2005; 19 1-16
- 19 Zieglmeier M. Einnahmeempfehlungen für orale Arzneimittel.. München: Wissenschaftliches Institut für Prävention im Gesundheitswesen (WIPIG); 2009
- 20 Flockhart D A. P450 Drug Interaction Table: Abbreviated „Clinically Relevant” Table.. http://medicine.iupui.edu/clinpharm/ddis/ClinicalTable.asp (Stand: 19.05.2011)
- 21 Boyer E W, Shannon M. The serotonin syndrome. N Engl J Med. 2005; 352 1112-1120
Constanze Rémi
Apotheke Klinikum der Universität München – Campus Großhadern
Marchioninistraße 15
81377 München
Email: constanze.remi@med.uni-muenchen.de