Læknablaðið - 15.01.2000, Síða 18

FRÆÐIGREINAR / OLDRUNARLÆKNINGAR
aðar á bráðasjúkrahúsi og til að leggja mat á gæði
lyfjameðferðar. Ekki er hægt að alhæfa um lyfjanotk-
un aldraðra á íslandi út frá rannsókninni. Lyfjameð-
ferð aldraðra er erfið og þarfnast stöðugs og reglu-
bundins eftirlits og endurmats þannig að vel takist til.
Hinn mikli líffræðilegi munur sem getur verið milli
jafnaldra þegar háum aldri er náð, gerir það að verk-
um að meðferðin verður alltaf að vera einstaklings-
bundin. Þrátt fyrir að varkárni og íhaldssemi sé af
hinu góða þarf samt að gæta þess að neita ekki
sjúklingum um meðferð sem er til hagsbóta.
Niðurstöður okkar ásamt þeim grófu gæðavísum
sem við beitum benda til þess að gera megi betur í
lyfjameðferð aldraðra sjúklinga, til dæmis með klín-
ískum leiðbeiningum í heilsugæslu, hjá sérfræðingum
á stofu og á sjúkrastofnunum.
Nokkur dæmi um mælikvarða á bestu lyfjameðfeð fyrir aldraða
Blóðþurrðarhjartasjúkdómur: Magnýl og betablokkandi lyf.
Hjartabilun: ACE-hemjandi lyf.
Gáttaflökt: Blóðþynning með warfaríni, þar sem ekki eru frábendingar.
Beinvernd: D-vítamín og kalk, mögulega kvenhormón, kvenhormónalíki eða
bisfosfónöt.
Verkjameðferð: Forðast ber gigtarlyf, ef notuð, velja hagstætt lyf í stuttan tíma
og þá með prótónupumpuhemjara.
Kvíða- og svefnvandamál: Lyf með hæfilega stuttan helmingunartíma.
Neuroleptica: Lágir skammtar, forðast andkólínvirkar aukaverkanir og
utanstrýtueinkenni. Mögulega nota nýrri kynslóðir þessara lyfja.
Þunglyndislyf: Forðast andkólínvirkar aukaverkanir þríhringlaga lyfja.
Mögulega nota nýrri kynslóðir sérhæfðra serótónín endurupptökuhemjara.
Þakkir
Rannsókn þessi er studd að hluta af Vísindasjóði
Sjúkrahúss Reykjavíkur.
Erni Olafssyni er þökkuð aðstoð við tölfræðilega
úrvinnslu.
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