Polypharmazie – Interaktionen bei älteren Menschen

Zusammenfassung

Thrombozytenaggregationshemmer und Antikoagulanzien sind wichtige Standardmedikationen in der Prophylaxe und Therapie kardiovaskulärer Erkrankungen. Die oft multiple Medikation und durch zusätzliche Begleiterkrankungen notwendige weitere Medikation birgt besonders bei älteren Patienten ein hohes Risiko von Arzneimittelwechselwirkungen. Diese können das Blutungsrisiko oder im Fall des Wirkungsverlusts das Risiko thromboembolischer Ereignisse erhöhen. In diesem Artikel werden klinisch relevante Interaktionen von COX-Hemmern (COX: Cyclooxygenase) und Adenosinrezeptorantagonisten sowie von Vitamin-K-Antagonisten und direkten oralen Antikoagulanzien (DOAK) wie auch Strategien zur Vermeidung unerwünschter Wirkungen diskutiert.

Abstract

Platelet aggregation inhibitors and anticoagulants are important standard medications in the prophylaxis and therapy of cardiovascular diseases. The additional medication required to treat comorbidities bears the potential risk of drug interactions on pharmacokinetic and pharmacodynamic level, especially in elderly patients. This may increase the risk of bleeding or, in the event of loss of efficacy, the risk of thromboembolic events. This article outlines clinically relevant interactions of COX inhibitors and adenosine receptor antagonists as well as of vitamin K antagonists and DOAC. In addition, strategies to avoid adverse effects are discussed.

Was ist wichtig

Die im Alter zunehmende Prävalenz kardiovaskulärer wie auch weiterer Erkrankungen bedingt nahezu regelhaft die Notwendigkeit der Polypharmazie und damit ein höheres Potenzial unerwünschter Arzneimittelwirkungen. Die Kenntnis über Arzneimittelinteraktionen nimmt daher einen besonderen Stellenwert in der Behandlungsstrategie insbesondere älterer Patienten ein.

Schlüsselwörter

P-Glycoprotein - Blutungsereignis - Thromboembolie - Interaktionen - Arzneistoffmetabolismus

Keywords

drug metabolism - P-glycoprotein - bleeding events - thromboembolism - interactions

Publication History

Article published online:
05 December 2022

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