Development of a pharmacological evidence-based anticholinergic burden scale for medications commonly used in older adults

被引:5
|
作者
Yamada, Shizuo [1 ]
Mochizuki, Masae [1 ]
Chimoto, Junko [1 ]
Futokoro, Risa [2 ]
Kagota, Satomi [2 ]
Shinozuka, Kazumasa [2 ]
机构
[1] Univ Shizuoka, Ctr Pharm Food Res CPFR, Grad Sch Pharmaceut Sci, 52-1 Yada,Suruga Ku, Shizuoka 4228526, Japan
[2] Mukogawa Womens Univ, Sch Pharm & Pharmaceut Sci, Nishinomiya, Japan
关键词
anticholinergic burden; Japan; medication lists; muscarinic receptors; PEOPLE; DRUGS; RISK; DELIRIUM; EXPOSURE; IMPACT; LOAD;
D O I
10.1111/ggi.14619
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
Aim: The present study aimed to develop a pharmacological evidence-based anticholinergic burden scale (ABS) through a direct assessment of muscarinic receptor-binding activities of 260 medications commonly used in older adults. Methods: The muscarinic receptor-binding activities of 260 drugs were assessed by the displacement of specific [N-methyl-H-3]scopolamine methyl chloride binding in the rat brain. The maximum blood concentrations (C-max) of drugs after their administration to subjects were cited from their interview forms. Results: In total, 96 of 260 drugs displayed concentration-dependent muscarinic receptor binding in rat brain. Based on muscarinic receptor-binding activity (IC50) and C-max after the administration at clinical doses in humans, we rated ABS 3 (strong) for 33 drugs and ABS 2 (moderate) for 37 drugs. There was an approximate similarity between muscarinic receptor-binding activities (IC50) and C-max of 33 drugs (ABS 3) after their administration at clinical doses in humans. Furthermore, 26 drugs were defined as ABS 1 (weak) by muscarinic receptor-binding activity. The remaining 164 drugs exhibited slight or no significant muscarinic receptor-binding activities at high concentration of 100 mu M, and they were defined as ABS 0. There was a marked similarity for 28 drugs (ABS 3) between the present ABS data and their previous scoring data in the literature. Conclusions: To our knowledge, the present study developed the first comprehensive pharmacological evidence-based ABS of drugs based on muscarinic receptor-binding activity, which provides guidance as to which drugs may be discontinued to reduce anticholinergic burden.
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页码:558 / 564
页数:7
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