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Besonderheiten der Pharmakotherapie in der Geriatrie

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Praktische Arzneitherapie

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Zusammenfassung

Ältere Patienten leiden vermehrt an Krankheiten des Bewegungsapparates, des kardiovaskulären und des Zentralnervensystems. Es ist deshalb verständlich, dass diese Patienten besonders häufig Arzneimittel erhalten. Allerdings ist zu beachten, dass sich die Lebenserwartung durch therapeutische Maßnahmen für die über 70-Jährigen nur relativ gering seit Beginn dieses Jahrhunderts verbessert hat: Ein 70-Jähriger hatte 1901 eine Lebenserwartung von 8 Jahren, 1981 von 10 Jahren, ein Gewinn von lediglich 2 Jahren, während sich bei einem Neugeborenen die Lebenserwartung um 26 Jahre erhöhte. Es gibt erstaunlich wenige Studien, die eine Verbesserung der Lebenserwartung für diese Patientengruppe aufzeigen. Die STOP-Hypertension-Studie hat in exemplarischer Weise eine Reduktion der Mortalität, der Inzidenz von Schlaganfällen und von tödlichen Schlaganfällen bei Patienten der Altersklasse 70–84 Jahre durch adäquate antihypertensive Therapie nachgewiesen [1]. Die meisten Medikamente werden alten Menschen verabreicht, ohne dass eine Lebenserwartungsverlängerung gezeigt wurde. Soweit es sich bei der therapeutischen Intention darum handelt, eine Verbesserung der Befindlichkeit herbeizuführen, mag deren Einsatz gerechtfertigt sein, bei prophylaktischen Maßnahmen (z. B. der Gabe von Cholesterinsenkern) ist ein Beweis für die klinisch relevante Wirkung (Verbesserung der Lebenserwartung oder der Lebensqualität) in dieser Altersgruppe jedoch unerlässlich.

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Authors
  1. J. C. Frölich
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Editors and Affiliations

  1. Institut für Klinische Pharmakologie, Medizinische Hochschule Hannover, D-30623, Hannover, Deutschland

    J. C. Frölich

  2. Medizinische Fakultät, Institut für Klinische Pharmakologie, Technische Universität Dresden, Fiedlerstr. 27, D-01307, Dresden, Deutschland

    W. Kirch

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Frölich, J.C. (2000). Besonderheiten der Pharmakotherapie in der Geriatrie. In: Frölich, J.C., Kirch, W. (eds) Praktische Arzneitherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-09398-6_7

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  • DOI: https://doi.org/10.1007/978-3-662-09398-6_7

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  • Print ISBN: 978-3-540-66071-2

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