Skip to main content
SpringerLink
Log in

Therapie mit Analgetika und Antirheumatika im Alter

  • Conference paper
Verhandlungen der Deutschen Gesellschaft für Innere Medizin

Part of the book series: Verhandlungen der Deutschen Gesellschaft für Innere Medizin ((VDGINNERE,volume 96))

  • 66 Accesses

Zusammenfassung

Schmerzzustände, insbesondere chronische Schmerzen, treten mit zunehmendem Lebensalter häufiger auf. Für die Bundesrepublik Deutschland wird die Zahl chronischer Schmerzpatienten auf ca. 3 Mio. geschätzt, von denen 400 000–500 000 erhebliche schmertherapeutische Probleme bereiten [95]. Nach einer repräsentativen Erhebung in Kanada liegt die Häufigkeit länger anhaltender Schmerzen bei 18–40 jährigen bei 8,5%, bei 49–60 jährigen über 16% und bei 61 jährigen bei 29%. Ein beträchtlicher Anteil der Schmerzpatienten sind Rheumakranke. Nach Schattenkirchner (zit. nach [95]) haben 5% der Bevölkerung Gelenkschmerzen, die ihre Lebensqualität stark beeinträchtigen. Betroffen sind v.a. die über 65 jährigen (Taylor u. Curran 1985). Ca. 50% der Krebskranken aller Stadien haben Schmerzen, in fortgeschrittenen Stadien steigt der Anteil auf 70–80% [11, 30]. Auch hier überwiegen ältere Menschen.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

Literatur

  1. Ammon HPT (1981) Arzneimittelneben-und-Wechselwirkungen. Dtsch. Apothekerverlag, Stuttgart.

    Google Scholar 

  2. Angell M (1982) The quality of mercy. N Engl J Med 306:98–99.

    Article  PubMed  CAS  Google Scholar 

  3. Bach B, Hansen JM, Kampmann JP, Rasmussen SN, Skovsted L (1981) Disposition of antipyrine and phenytoin correlated with age and liver volume in man. Clin Pharmacokinet 6:389–396.

    Article  PubMed  CAS  Google Scholar 

  4. Ball M, Moore RA, Fisher A, McQuay JH, Allen MC, Sear J (1985) Renal failure and the use of morphine in intensive care. Lancet I:784–786.

    Article  Google Scholar 

  5. Baskin SI, Smith L, Hoey LA; Levy PI, Goldfarb AH (1981) Age-associated changes of responses to acetylsalicylic acid. Pain 11:1–8.

    Article  PubMed  CAS  Google Scholar 

  6. Bayliss RIS (1984) A physician looks at adverse drug reactions in the elderly. In: Butler RN, Beam AG (eds) The aging process: therapeutic implications. Raven, New York, pp 161–169.

    Google Scholar 

  7. Belville JM, Forrest WH, Miller E, Brown BWJ (1971) Influence of age on pain relief from analgesics. A study of postoperative patients. JAMA 217:1835–1841.

    Article  Google Scholar 

  8. Benet LZ, Sheiner LB (1985) Design and optimization of dosage regimens; pharmacokinetic data. In: Goodman-Gilman A, Goodman LS, Rall TW, Murad F (eds) The pharmacological basis of therapeutics, 7th edn. McMillan, New York, pp 1663–1733.

    Google Scholar 

  9. Bentley JB, Borel JD, Nenand RE, Gillespie TJ (1982) Age and fentanyl kinetics. Anaesthet Analget 61:968–971.

    CAS  Google Scholar 

  10. Berkowitz BA, Ngai SH, Yang JC, Hempstead J, Spector S (1975) The disposition of morphine in man. Clin Pharmacol Ther 17:629–635.

    PubMed  CAS  Google Scholar 

  11. Bonica JJ (1985) Treatment of cancer pain: current status and future needs. Adv Pain Res Ther 9:589–616.

    Google Scholar 

  12. Brannon W, McCormick W, Lampert P (1967) Axonal dystrophy in the gracile nucleus of man. Acta Neuropathol (Berl) 9:1–6.

    Article  CAS  Google Scholar 

  13. Braverman AM (1982) Therapeutic considerations in prescribing for elderly patients. Eur J Rheumatol Inflamm 5:289–293.

    PubMed  CAS  Google Scholar 

  14. Breitkreuz G (1982) Arzneimittelbestand in den Händen alter Menschen. Med. Dissertation, Universität Berlin.

    Google Scholar 

  15. Briant RH, Dorrington RE, Cleal J, Williams FM (1976) The rate of acetaminophen metabolism in the elderly and the young. J Am Geriatr Soc 24:359–361.

    CAS  Google Scholar 

  16. Brown WW, Davis BB, Spry LA, Wongsurawat N, Malone D, Domoto DT (1986) Aging and the kidney. Arch Intern Med 146:1790–1796.

    Article  PubMed  CAS  Google Scholar 

  17. Chan K, Kendall MJ, Mitchard M, Wells WDE (1975) The effect of aging on plasma pethidin concentration. Br J Clin Pharmacol 2:297–302.

    PubMed  CAS  Google Scholar 

  18. Chapman WP, Jones CM (1944) Variations in cutaneous and visceral pain sensitivity in normal subjects. J Clin Invest 23:81–91.

    Article  PubMed  CAS  Google Scholar 

  19. Clive DM, Stoff JS (1984) Renal syndromes associated with nonsteroidal antiinflammatory drugs. N Engl J Med 310:563–572.

    Article  PubMed  CAS  Google Scholar 

  20. Coper K, Schulze G (1980) Pharmakotherapie im Alter. Urban & Schwarzenberg, München Wien Baltimore.

    Google Scholar 

  21. Crook J (1983) Aging and drug disposition. J Chronic Dis 36:85–90.

    Article  Google Scholar 

  22. Crook J, Rideout E, Browne G (1984) The prevalence of pain complaints in a general population. Pain 18:299–314.

    Article  PubMed  CAS  Google Scholar 

  23. Cuny G, Royer RJ, Mur JM, et al. (1979) Pharmacokinetics of salicylate in the elderly. Gerontology 25:49–55.

    Article  PubMed  CAS  Google Scholar 

  24. Desmedt JE, Cheron G (1980) Somato sensory evoked potentials in healthy octogenarians and in young adults: wave form, scalp topography and transit times of parietal and frontal components. Electroencephalogr Clin Neurophysiol 50:404–425.

    Article  PubMed  CAS  Google Scholar 

  25. Divoll M, Greenblatt DJ, Ameer B, Abernathy DR (1982) Effect of food on acetaminophen absorption in young and elderly subjects. J Clin Pharmacol 22:571–576.

    PubMed  CAS  Google Scholar 

  26. Dubach UC, Rossner B, Pfister E (1983) Epidemiologic study of abuse of analgesics containing phenacetin. N Engl J Med 308:357–362.

    Article  PubMed  CAS  Google Scholar 

  27. Dunn MJ (1984) Nonsteroidal antiinflammatory drugs and renal function. Annu Rev Med 35:411–428.

    Article  PubMed  CAS  Google Scholar 

  28. Emori HW, Paulus H, Bluestone R, Champion GD, Pearson C (1976) Indomethacin serum concentrations in man. Effects of dosage, food and antacid. Ann Rheum Dis 35:333–338.

    Article  PubMed  CAS  Google Scholar 

  29. Falck I (1985) Schmerzbehandlung in der Geriatric In: Hackenthal E, Worz R (Hrsg) Schmerzbehandlung in der Praxis. Fischer, Stuttgart, S 275–291.

    Google Scholar 

  30. Foley KM (1985) The treatment of cancer pain. N Engl J Med 313:84–95.

    Article  PubMed  CAS  Google Scholar 

  31. Galeazzi RL (1977) The effect of an antacid on the bioavailability of indomethacin. Eur J Clin Pharmacol 12:65–68.

    Article  PubMed  CAS  Google Scholar 

  32. Girdwood RH (1974) Deaths after taking medicaments. Br Med J 1:501–504.

    Article  PubMed  CAS  Google Scholar 

  33. Greenblatt DJ, Abernathy DR, Divoll M, Ochs HR, Shader RI (1983) Antipyretic analgesic drugs as models for studies of drug disposition in old age. Am J Med 75A:127–132.

    Article  Google Scholar 

  34. Hackenthal E (1985) Pharmakologie der Opioid-Analgetika. In: Hackenthal E, Wörz R (Hrsg) Medikamentöse Schmerzbehandlung. Fischer, Stuttgart, S 99–168.

    Google Scholar 

  35. Hackenthal E, Wörz R (1985) Analgetika: Irrationale Anwendung, Mißbrauch und Abhängigkeit. In: Hackenthal E, Wörz RH (Hrsg) Medikamentöse Schmerzbehandlung in der Praxis. Fischer, Stuttgart, S 325–373.

    Google Scholar 

  36. Harkins S, Chapman CR (1976) Detection and decision factors in pain perception in young and elderly man. Pain 2:253–264.

    Article  PubMed  CAS  Google Scholar 

  37. Hart FD, Huskisson EC (1984) Non-steroidal anti-inflammatory drugs. Current status and rational therapeutic use. Drugs 27:232–255.

    Article  PubMed  CAS  Google Scholar 

  38. Hunt TE (1976) Management of chronic non-rheumatic pain in the elderly. J Am Geriatr Soc 24:402–406.

    PubMed  CAS  Google Scholar 

  39. Huskisson EC (1983) NSAIDs — a topical review. Geriatr Med 13:867–870.

    Google Scholar 

  40. Illy H, Jork K (1983) Über Krankheitsverständnis von Patienten und Selbsttherapie. Prakt Arzt 8:578–588.

    Google Scholar 

  41. Inman WHW (1984) Postmarketing surveillance: adverse drug reactions and event monitoring. In: Butler RN, Bearn AG (eds) The aging process: therapeutic implications: Raven, New York, pp 143–160.

    Google Scholar 

  42. Jellinger K, Jirasek A (1971) Neuroaxonal dystrophy in man: character and natural history. Acta Neuropathol (Berl) 5:3–16.

    Google Scholar 

  43. Jori A, Disalle E, Quadri A (1972) Rate of aminopyrine disappearance from plasma in young and aged humans. Pharmacology 8:273–279.

    Article  PubMed  CAS  Google Scholar 

  44. Kaiko RF (1980) Age and morphine analgesia in cancer patients with postoperative pain. Clin Pharmacol Ther 28:823–826.

    Article  PubMed  CAS  Google Scholar 

  45. Kenshalo DR (1986) Somesthetic sensitivity in young and elderly humans. J Gerontol 41:732–742.

    PubMed  Google Scholar 

  46. Kincaid-Smith P (1986) Effects of non-narcotic analgesics on the kidney. Drugs 32[Suppl 4]:109–128.

    Article  PubMed  Google Scholar 

  47. Klotz V, McHorse TS, Wilkinson GR, Schenker S (1974) The effect of cirrhosis on the disposition of meperidine in man. Clin Pharmacol Ther 16:667–675.

    PubMed  CAS  Google Scholar 

  48. Krupka LR, Vener AM (1979) Hazards of drug use among the elderly. Gerontology 19:90–95.

    Article  CAS  Google Scholar 

  49. Langman MJS, Morgan L, Worrall A (1985) Use of anti-inflammatory drugs by patients admitted with small or large bowel perforation and haemorrhage. Br Med J 290:347–349.

    Article  CAS  Google Scholar 

  50. Lasagna L, Mosteller F, Feisinger JM von (1954) A study of the placebo response. Am J Med 16:770–779.

    Article  PubMed  CAS  Google Scholar 

  51. Lee P, McKusker S, Allison A, Nuki G (1973) Adverse reactions in patients with rheumatic diseases. Ann Rheum Dis 32:565–573.

    Article  PubMed  CAS  Google Scholar 

  52. Lemmer B (1984) Tagesrhythmen und Arzneimittelwirkung. In: Lemmer B (Hrsg) Chronopharmakologie. Wissenschaftliche Verlagsgesellschaft, Stuttgart, S 18–25.

    Google Scholar 

  53. Lesko LJ, Narang PK, Yeager L, Cutler NR (1985) Salicylate protein binding in serum from young and elderly subjects as measured by diafiltration. Eur J Clin Pharmacol 28:339–345.

    Article  PubMed  CAS  Google Scholar 

  54. Levy M, Kewitz H, Altwein W, Hillebrand J, Eliakim M (1980) Hospital admission due to adverse drug reactions: a comparative study from Israel and Berlin. Eur J Clin Pharmacol 17:25–31.

    Article  PubMed  CAS  Google Scholar 

  55. Mather LE, Tucker GT, Pflug AE, Lindop MJ, Wilkerson C (1975) Meperidine kinetics in man: intravenous injection of surgical patients and volunteers. Clin Pharmacol Ther 17:21–30.

    PubMed  CAS  Google Scholar 

  56. Mihatsch MJ (1986) Das Analgetika-Syndrom. Thieme, Stuttgart New York.

    Google Scholar 

  57. Moore A, Sear J, Baldwin D, Allen MC, Hunniset A, Bullingham R, McQuay H (1984) Morphine kinetics during and after renal transplantation. Clin Pharmacol Ther 35:641–645.

    Article  PubMed  CAS  Google Scholar 

  58. Nanra RS (1983) Renal effects of antipyretic analgesics. Am J Med 75A:70–81.

    Google Scholar 

  59. Nuki G, Burley L (1984) Nonsteroidal analgesic anti-inflammatory drugs in the elderly. In: Butler RN, Beam AG (eds) The aging process: therapeutic Implications. Raven, New York, pp 207–228.

    Google Scholar 

  60. Paffrath D (1989) Arzneimittelverordnungen nach Altersgruppen. In: Schwabe U, Paffrath D (Hrsg) Arzneiverordnungsreport 89. Fischer, Stuttgart, S 416–425.

    Google Scholar 

  61. Pickup ME (1983) Drug pharmacokinetics with reference to anti-rheumatic drugs. In: Wright V (ed) Bone and joint disease in the eldery. Churchill-Livingstone, Edinburgh, pp 197–221.

    Google Scholar 

  62. Pommer W, Bronder E, Offermann G, Schwarz A, Molzahn M (1986) Schmerzmittelkonsum und Analgetika-Nephropathie. Ausmaß, Häufigkeit und Kosten — Daten für die BRD und Berlin (West). MMW 128:220–223.

    Google Scholar 

  63. Pommer W, Glaeske G, Molzahn M (1987) Analgetika-Verbrauch in der Bundesrepublik Deutschland. Ausmaß und Risikogruppen. Dtsch Med Wochenschr 112:787–790.

    Article  PubMed  CAS  Google Scholar 

  64. Portenoy RK, Foley KM (1986) Chronic use of opioid analgesics in non-malignant pain: report of 38 cases. Pain 25:171–186.

    Article  PubMed  CAS  Google Scholar 

  65. Pratt H, Amlie RN, Starr A (1979) Sensory potentials in human evoked by both mechanical stimulation of the skin and electrical stimulation of nerve. In: Kenshalo DR (ed) Sensory functions of the skin in humans. Plenum, New York.

    Google Scholar 

  66. Procacci P, Bozza G, Buzell G, Della Corte M (1970) The cutaneous pain pricking threshold in old age. Gerontol Clin 12:213:218.

    Article  CAS  Google Scholar 

  67. Richey DP, Bender AD (1977) Pharmacokinetic consequences of aging. Annu Rev Pharmacol Toxicol 17:49–65.

    Article  PubMed  CAS  Google Scholar 

  68. Riley GA (1977) How aging influences drug therapy. US Pharm 2:28–46.

    Google Scholar 

  69. Roberts MS, Rumble RH, Wanwimolruk S, Thomas D, Brooks PM (1983) Pharmacokinetics of aspirin and salicylate in elderly subjects and in patients with alcoholic liver disease. J Clin Pharmacol 25:253–261.

    Article  CAS  Google Scholar 

  70. Salem SAM (1978) Reduced induction of drug metabolism in the elderly. Age Ageing 7:68–73.

    Article  PubMed  CAS  Google Scholar 

  71. Salem SAM, Stevenson IH (1977) Absorption kinetics of aspirin and quinine in elderly subjects. Br J Clin Pharmacol 4:397P.

    PubMed  CAS  Google Scholar 

  72. Schmidt G (1989) Analgetika. In: Schwabe U, Paffrath D (Hrsg) Arzneiverordnungsreport 89. Fischer, Stuttgart, S 20–30.

    Google Scholar 

  73. Schönhöfer PS (1983) Benoxaprofen: Ein unerwartetes neues Arzneimittelproblem? Pharmazeut Ztg 128:735–739.

    Google Scholar 

  74. Schwarz A, Faber U, Glaeske G, Keller F, Offermann G, Pommer W, Molzahn M (1985) Daten zu Analgetika-Konsum und Analgetika-Nephropathie in der Bundesrepublik. Off Gesundheitswes 47:298–300.

    CAS  Google Scholar 

  75. Segre J (1979) Drug interactions with naproxen. Eur J Rheumatol Inflamm 2:12–18.

    CAS  Google Scholar 

  76. Sherman ED (1943) Sensitivity to pain. Can Med Assoc J 48:437–441.

    PubMed  CAS  Google Scholar 

  77. Sherman ED, Robillard E (1960) Sensitivity to pain in the aged. Can Med Assoc J 83:944–947.

    PubMed  CAS  Google Scholar 

  78. Stambaugh JE, Wainer IW, Sanstead JK, Hemphill DM (1976) The clinical pharmacology of meperidine-comparison of routes of administration. J Clin Pharmacol 16:245–256.

    PubMed  CAS  Google Scholar 

  79. Stimmel B (1983) Management of pain in special populations. In: Pain, analgesics and addiction. Raven, New York, pp 280–302.

    Google Scholar 

  80. Stjernsward J (1985) Cancer pain relief: an important global public health issue. Adv Pain Res Ther 9:555–558.

    Google Scholar 

  81. Strempel H (1981) Der duale Charakter des Schmerzes. Dtsch Arztebl 2017.

    Google Scholar 

  82. Szeto HH, Inturrisi CE, Houde R, Saal S, Cheigh J, Reidenberg MM (1977) Accumulation of normeperidine, an active metabolite of meperidine, in patients with renal failure or cancer. Ann Intern Med 86:738–741.

    PubMed  CAS  Google Scholar 

  83. Taylor M, Galloway DB, Petrie JC, Davidson JE, Gallon SC, Moir DC (1978) Psychomimetic effects of pentazocine and dihydrocodeine tartrate. Br Med J 2:1198.

    Article  PubMed  CAS  Google Scholar 

  84. Triggs EJ, Nation RL, Long A, Ashley JJ (1975) Pharmacokinetics in the elderly. Eur J Clin Pharmacol 8:55–62.

    Article  PubMed  CAS  Google Scholar 

  85. Upton RA; Williams RL, Kelly J, Jones RM (1984) Naproxen pharmacokinetics in the elderly. Br J Clin Pharmacol 18:207–214.

    PubMed  CAS  Google Scholar 

  86. Veerbeeck R, Tjandramaga TB, Mullie A, Verbesselt R, deSchepper PJ (1979) Effect of aluminium hydroxide on diflunisal absorption. Br J Clin Pharmacol 7:519–522.

    Google Scholar 

  87. Veerbeeck RK, Blackburn JL, Loewen GR (1983) Clinical pharmacokinetics of non-steroidal anti-inflammatory drugs. Clin Pharmacokinet 8:297–331.

    Article  Google Scholar 

  88. Ventafridda V, Tamburini M, Caraceni A, DeConno F, Nabli F (1987) A validation study of the WHO method for cancer pain relief. Cancer 59:850–856.

    Article  PubMed  CAS  Google Scholar 

  89. Vestal RE (1978) Drug use in the elderly: a review of problems and special considerations. Drugs 16:358–382.

    Article  PubMed  CAS  Google Scholar 

  90. Wegmüller (1985) Nicht-steroidale Antirheumatika und Nephrotoxizität. Dtsch Med Wochenschr 110:469–472.

    Article  PubMed  Google Scholar 

  91. Williamson J (1978) Prescribing problems in the elderly. Practitioner 220:749–755.

    PubMed  CAS  Google Scholar 

  92. Woolner DF, Winter D, Frendin TJ, Begg EJ, Lynn KL, Wright GJ (1986) Renal failure does not impair the metabolism of morphine. Br J Clin Pharmacol 22:55–59.

    PubMed  CAS  Google Scholar 

  93. Wörz R (1983) Effects and risks of psychotropic and analgesic combinations. Am J Med 75A:139–140.

    Article  Google Scholar 

  94. Zenz R, Tryba M, Steffmann R, Rohrs E (1986) Langzeittherapie mit Morphin-Retard-Tabletten. In: Doenicke A (Hrsg) Schmerz. Eine interdisziplinäre Herausforderung. Springer, Berlin Heidelberg New York Tokyio.

    Google Scholar 

  95. Zimmermann M, Seemann H (1986) Der Schmerz. Ein vernachlässigtes Gebiet der Medizin? Springer, Berlin Heidelberg New York Tokyo.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pharmakologisches Institut, Universität Heidelberg, Deutschland

    E. Hackenthal

Authors
  1. E. Hackenthal
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1990 Springer-Verlag, Berlin Heidelberg

About this paper

Cite this paper

Hackenthal, E. (1990). Therapie mit Analgetika und Antirheumatika im Alter. In: Verhandlungen der Deutschen Gesellschaft für Innere Medizin. Verhandlungen der Deutschen Gesellschaft für Innere Medizin, vol 96. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84317-4_54

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-84317-4_54

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-53256-9

  • Online ISBN: 978-3-642-84317-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation