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R A N N S Ó K N
Heimildir
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ENGLISH SUMMARY
Introduction: A pharmacoepidemiological study was conducted to ana-
lyse the relationship between bone fracture and the use of certain drugs.
Material/methods: The study includes patients 40 years and older,
diagnosed with bone fractures in the Emergency Department of
Landspitali University Hospital in Reykjavik, Iceland, during a 10-year
period (2002-2011). Also were included those who picked up from a
pharmacy 90 DDD or more per year of the drugs included in the study
in the capital region of Iceland during same period. Opiates, benzodi-
azepines/hypnotics (sedatives) were compared with HMG-CoA reduct-
ase inhibitors (statins), non-steroid anti-inflammatory drugs (NSAID) and
beta blockers. Proton-pump inhibitors (PPI) and histamine H2-antagon-
ists were also examined. To examine the association between above
drugs and fractures the data from electronic hospital database were
matched to the prescription database run by the Directorate of Health.
Results: A total of 29,056 fractures in 22,891 individuals were identified.
The females with fractures were significantly older and twice as many,
compared to males. The odds ratio (OR) for fractures was not signi-
ficantly different between the NSAID, statins and beta blockers. OR for
opiates showed almost double increased risk of fractures, 40% increa-
sed risk for sedatives and 30% increased risk for PPIs compared to beta
blockers. No increased fracture-risk was noted in patients taking H2
antagonists.
Conclusion: This study shows a relationship between the use of opi-
ates, sedatives and bone fractures. The incidence of fractures was also
increased in patients taking PPIs which is interesting in the light of the
wide-spread use of PPIs in the community.
Do opioids, sedatives and proton-pump inhibitors increase the risk of fractures?
Guðlaug Þórsdóttir1, Elísabet Benedikz2, Sigríður A. Þorgeirsdóttir3, Magnús Jóhannsson3
1Geriatric Clinic, 2Department of Quality and Patient Safety, Landspitali University Hospital, Reykjavik, Iceland, 3Department of Pharmacology and Toxicology, Faculty of medicine,
University of Iceland, Reykjavik, Iceland
Key words: Opiates, sedatives, proton- pump inhibitors, fractures.
Correspondence: Magnús Jóhannsson, magjoh@hi.is
vert þar sem áhrif mismunandi flokka ópíata á efnaskipti beina og
jafnvægi getur verið breytileg.27
Samantekið sýnir þessi rannsókn að einstaklingar sem taka
ópíöt eða svefn- og róandi lyf eru í marktækt meiri hættu fyrir
beinbrot en einstaklingar sem taka gigtarlyf, beta-blokka, statín
eða H2-andhistamín. Einstaklingar sem taka PPI eru í marktækt
meiri hættu á beinbrotum en einstaklingar sem taka beta-blokka.
Líkleg skýring á aukinni brotatíðni hjá einstaklingum sem taka
ópíöt eða svefn- og róandi lyf er aukin byltuhætta vegna áhrifa
á miðtaugakerfi. Að auki hafa ópíöt áhrif á efnaskipti beina sem
sennilega á einnig við um PPI.