DRUG-INDUCED COGNITIVE IMPAIRMENT - DEFINING THE PROBLEM AND FINDING SOLUTIONS

被引:48
作者
BOWEN, JD [1 ]
LARSON, EB [1 ]
机构
[1] UNIV WASHINGTON, DEPT MED, DIV NEUROL, ALZHEIMERS DIS PATIENT REGISTRY, SEATTLE, WA 98195 USA
关键词
D O I
10.2165/00002512-199303040-00005
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Drug-induced cognitive impairment is a common cause of delirium and is frequently a confounding factor in dementia. Predisposing conditions for delirium include age, brain disease and addiction to alcohol and/or drugs. The elderly are at particular risk because of multiple diseases, multiple drug use and alterations of drug metabolism associated with age. Sedatives such as benzodiazepines have a particularly high risk of cognitive impairment. Centrally acting sympathetic antihypertensive agents, sedating antipsychotic drugs, opioids, digitalis, anti-Parkinsonian drugs, antidepressants and corticosteroids are also associated with greater risk relative to other classes of medications. Cognitive impairment due to medication may be reduced by recognition of the problem. The risk of drug-induced impairment may be minimised by strategies which optimise overall health, avoidance of unnecessary medications, and selection of medications least likely to cause delirium.
引用
收藏
页码:349 / 357
页数:9
相关论文
共 41 条
[1]  
[Anonymous], 1972, CLIN PHARMACOL THER, V13, P694
[2]  
[Anonymous], 1990, DELIRIUM ACUTE CONFU
[3]   CHRONIC SALICYLATE INTOXICATION - A COMMON CAUSE OF MORBIDITY IN THE ELDERLY [J].
BAILEY, RB ;
JONES, SR .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 1989, 37 (06) :556-561
[4]  
BUCHANAN WW, 1990, J RHEUMATOL, V17, P29
[5]   CLINICAL PHARMACOKINETIC CONSIDERATIONS IN THE ELDERLY - AN UPDATE [J].
DAWLING, S ;
CROME, P .
CLINICAL PHARMACOKINETICS, 1989, 17 (04) :236-263
[6]   NEUROPSYCHOLOGICAL SIDE-EFFECTS OF BETA-BLOCKERS [J].
DIMSDALE, JE ;
NEWTON, RP ;
JOIST, T .
ARCHIVES OF INTERNAL MEDICINE, 1989, 149 (03) :514-525
[7]  
EISENDRATH SJ, 1987, AM J PSYCHIAT, V144, P1062
[8]   DEMENTIA AMONG MEDICAL INPATIENTS - EVALUATION OF 2000 CONSECUTIVE ADMISSIONS [J].
ERKINJUNTTI, T ;
WIKSTROM, J ;
PALO, J ;
AUTIO, L .
ARCHIVES OF INTERNAL MEDICINE, 1986, 146 (10) :1923-1926
[9]   A PROSPECTIVE-STUDY OF DELIRIUM IN HOSPITALIZED ELDERLY [J].
FRANCIS, J ;
MARTIN, D ;
KAPOOR, WN .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1990, 263 (08) :1097-1101
[10]   PSYCHOTIC COMPLICATIONS OF LONG-TERM LEVODOPA TREATMENT OF PARKINSONS-DISEASE [J].
FRIEDMAN, A ;
SIENKIEWICZ, J .
ACTA NEUROLOGICA SCANDINAVICA, 1991, 84 (02) :111-113