転倒事故に及ぼす睡眠薬の選択の影響とその防止策

書誌事項

タイトル別名
  • Evaluation of Relationship between Hypnotic Drugs and Risk of Injurious Falls, and Prevention of Falls
  • Evaluation of Relationship between Hypnotic Drugs and Risk of Injurious Falls, and Prevention of Falls-Role of pharmacist in medical safety management-
  • -Role of pharmacist in medical safety management-
  • -医療安全対策における薬剤師の役割-

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説明

The effects of hypnotics are one of the many causes of falls.However few studies have been done on a relationship between falls and hypnotics use in Japan.<br>We studied 109 patients who had experienced falls in hospital.The male to female ratio was 6:4,mean age was 67 years,22% of them had hepatic dysfunction,and 12% had renal dysfunction.Among them,38.5% were on hypnotics,and other frequently prescribed drugs were diuretics,analgesic antipyretics and laxatives.The incidence of falls for hypnotics was higher in subjects on the ultra-short-acting type (1.6 to 6.2%) than in those on the short-acting type (5.0 to 6.8%).For ultra-short-acting hypnotics,the incidences were similar in the daytime and nighttime,but for short-acting hypnotics,the incidence was higher in the daytime than in the nighttime,suggesting a persistent diurnal effect.<br>A questionnaire survey of physicians revealed that they selected hypnotics mainly based on the types of insomnia,duration of the hypnotic’s effect and the age of patients.They paid only a little attention to hepatic or renal function or metabolic pathways in patients.In order to prevent falls,we posted a recommendation in our electronic medical records system that physicians prescribe ultra-short-acting hypnotics whenever possible.Afterwards,the number of patients prescribed ultrashort-acting hypnotics increased by 75% and the number of patients who experienced falls during treatment with hypnotics decreased from 42 to 25 over a 4-month observation period.<br>Our findings suggest that it is important to select hypnotics for elderly patients in consideration of hepatic function,which may influence the lingering effects of hypnotics.

収録刊行物

  • 医療薬学

    医療薬学 37 (4), 253-260, 2011

    一般社団法人日本医療薬学会

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詳細情報 詳細情報について

  • CRID
    1390001204777099648
  • NII論文ID
    130004696142
  • DOI
    10.5649/jjphcs.37.253
  • ISSN
    18821499
    1346342X
  • 本文言語コード
    ja
  • データソース種別
    • JaLC
    • Crossref
    • CiNii Articles
  • 抄録ライセンスフラグ
    使用不可

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