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Pharmakotherapie bei Alterspatienten

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Altersdepression

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Zusammenfassung

Aufgrund pharmakokinetischer und pharmakodynamischer Veränderungen finden sich bei alten Patienten eine veränderte Wirksamkeit und Verträglichkeit von Arzneimitteln im Vergleich zu Jüngeren. Altersbedingt sind u. a. die Absorption im Magen-Darm-Trakt, die Verteilung im Körper und die Metabolisierung in der Leber verändert, allerdings nicht bei jedem Alterspatienten in gleicher Weise. Dies führt zu hoher pharmakologischer Variabilität. Zur Risikominimierung der Pharmakotherapie sollten inadäquate Medikamente wegen Verträglichkeitsproblemen, Polypharmazie wegen möglicher unerwünschter Arzneimittelwechselwirkungen, gleichzeitig aber auch eine medikamentöse Unterversorgung vermieden werden. Es sollte während der medikamentösen Behandlung ein enges Monitoring bzgl. Wirksamkeit und Verträglichkeit erfolgen. Blutspiegelmessungen von Psychopharmaka sollten genutzt werden, um pharmakokinetische Besonderheiten und die bei Alterspatienten häufigen Complianceprobleme zu erkennen.

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Authors and Affiliations

  1. Universitätsmedizin Mainz, Klinik für Psychiatrie und Psychotherapie, Untere Zahlbacher Str. 8, 55131, Mainz, Deutschland

    Christoph Hiemke

  2. Berndesallee 66, 55262, Heidesheim, Deutschland

    Gudrun Hefner

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  1. Christoph Hiemke
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  2. Gudrun Hefner
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Correspondence to Christoph Hiemke .

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  1. Abteilung für Gerontopsychiatrie Rheinhessen-Fachklinik Landeskrankenhaus (AöR), Alzey, Germany

    Andreas Fellgiebel

  2. Fachbereich Psychologie, Eberhard-Karls-Universität Tübingen, Tübingen, Germany

    Martin Hautzinger

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Hiemke, C., Hefner, G. (2017). Pharmakotherapie bei Alterspatienten. In: Fellgiebel, A., Hautzinger, M. (eds) Altersdepression. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53697-1_12

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