Zusammenfassung
Die Analyse der präoperativen Medikation dient der Nutzen-Risiko-Abschätzung, ob die
Dauermedikation perioperativ weitergegeben oder abgesetzt werden soll – die Risikobeurteilung
sorgt aber oft für Unsicherheit. Typische Herausforderungen sind medikamentöse Unter-
und Überversorgung, unerwünschte Arzneimittelwirkungen und -interaktionen sowie individuelle
Besonderheiten, die zu verlängerter Wirkdauer und erhöhter Dosisexposition führen
können.
Abstract
Analysis of preoperative medication is used to assess the benefit and risk associated
with continuing or discontinuing medication before and during surgery. Identifying
adverse drug reactions and assessing its risks often leads to uncertainty. Typical
challenges are medication underuse, but also overuse occurs and is often more difficult
to recognize, especially in the context of drug interactions and individual patient
characteristics.
Typical consequences of multi-medication and medical overuse may include an increased
potential for drug interactions, an increased risk of adverse drug reactions and medication
errors, and in particular in older adults, geriatric syndromes may occur or worsen.
Adverse drug reactions may occur as a result of the dose administered and as an effect
of time of exposure. Older, multi-morbid, and multi-medicated patients are often affected
by adverse drug reactions. For drugs primarily metabolized via the phase I enzymes
CYP2D6, CYP2C9, or CYP2C19, pharmacogenetically rapid or slow metabolism may result
in altered drug exposures. Clinically relevant pharmacokinetic drug interactions frequently
occur with drugs primarily metabolized via the phase I enzyme CYP3A4.
Schlüsselwörter
präoperative Medikation - unerwünschte Arzneimittelwirkungen - Multimedikation - Pharmakogenetik
- Arzneimittelinteraktionen
Key words
preoperative medication - adverse drug reaction - multimedication - pharmacogenetics
- drug-drug interaction
