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Aspekte der Polypharmazie beim alten Patienten

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Geriatrische Notfallversorgung

Zusammenfassung

Von den derzeit in Österreich ca.12.330 zugelassenen Humanarzneimitteln (Stand 2012) sind rund 32 % rezeptfrei in der Apotheke erhältlich. Neben den vom Arzt verordneten Arzneimitteln erfolgt zusätzlich Selbstmedikation mit registrierten und nicht registrierten sog. Over The Counter (OTC)-Produkten. So nimmt ein Patient ab dem 60. Lebensjahr im Mittel 3 rezeptpflichtige Arzneimittel ein, zwischen dem 75. und dem 85. Lebensjahr bereits mehr als 8 vom Arzt verordnete Medikamente. Die Häufigkeit an theoretisch möglichen Arzneimittelinteraktionen korreliert mit der Anzahl an Arzneimitteln [26]: Bei einer Anzahl von 5 Arzneimitteln gibt es theoretisch schon 10 mögliche Arzneimittelinteraktionen; bei 7 Arzneimitteln bereits 21 Interaktionen (◘ Abb. 30.1). Die Polypharmakotherapie beim alten Patienten, meist verursacht durch Multimorbididät, physiologische Veränderungen im Alter und damit verbundene Änderungen im Arzneistoffmetabolismus, und die adjuvante Selbstmedikation erhöhen in Summe das Risiko für das Auftreten unerwünschter und teilweise unerwarteter Arzneimittelwirkungen (UAW). Oftmals werden UAW als solche nicht erkannt, sondern als neu aufgetretene Krankheiten bewertet und therapiert. Daraus resultieren Verschreibungskaskaden, die wiederum das Risiko weiterer UAW erhöhen.

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Author information

Authors and Affiliations

  1. Apotheke des LKH Graz West, Landeskrankenhaus Graz West, Göstinger Str. 22, A-8020, Graz, Österreich

    Ingrid Friedl Dr.

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  1. Ingrid Friedl Dr.
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Editors and Affiliations

  1. Abteilung für Akutgeriatrie/Remobilisati, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

    Georg Pinter

  2. Intensivmedizin, Landeskrankenhaus Klagenfurt (LKH) Abt. Anaesthesiologie und, Klagenfurt, Austria

    Rudolf Likar

  3. Abteilung für Innere Medizin, Albert Schweitzer Klinik, Graz, Austria

    Walter Schippinger

  4. Institut für Psychologie, Alpen-Adria-Universität Klagenfurt, Klagenfurt, Austria

    Herbert Janig

  5. Gesundheits- und Pflegemanagement, Fachhochschule Kärnten, Klagenfurt, Austria

    Olivia Kada

  6. Stabstelle Multiprojektmanagement, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria

    Karl Cernic

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Friedl, I. (2013). Aspekte der Polypharmazie beim alten Patienten. In: Pinter, G., Likar, R., Schippinger, W., Janig, H., Kada, O., Cernic, K. (eds) Geriatrische Notfallversorgung. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1581-7_30

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  • DOI: https://doi.org/10.1007/978-3-7091-1581-7_30

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  • Online ISBN: 978-3-7091-1581-7

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