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Titolo:
Oxidative and nonoxidative benzodiazepines and the risk of femur fracture
Autore:
Sgadari, A; Lapane, KL; Mor, V; Landi, F; Bernabei, R; Gambassi, G;
Indirizzi:
Brown Univ, Sch Med, Ctr Gerontol & Hlth Care Res, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 lth Care Res, Providence, RI 02912 USA Catholic Univ Sacred Heart, Ist Med Interna & Geriat, I-00168 Rome, Italy Catholic Univ Sacred Heart Rome Italy I-00168 eriat, I-00168 Rome, Italy Brown Univ, Sch Med, Dept Community Hlth, Providence, RI 02912 USA Brown Univ Providence RI USA 02912 mmunity Hlth, Providence, RI 02912 USA
Titolo Testata:
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
fascicolo: 2, volume: 20, anno: 2000,
pagine: 234 - 239
SICI:
0271-0749(200004)20:2<234:OANBAT>2.0.ZU;2-#
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELIMINATION HALF-LIFE; HIP FRACTURE; GERIATRIC PHARMACOEPIDEMIOLOGY; THERAPEUTIC CONSIDERATIONS; CLINICAL PHARMACOKINETICS; ANTIPYRINE DISPOSITION; RESIDENT ASSESSMENT; DRUG-USE; DIAZEPAM; ALPRAZOLAM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Lapane, KL Brown Univ, Sch Med, Ctr Gerontol & Hlth Care Res, Box G-B222,171 Meeting St, Providence, RI 02912 USA Brown Univ Box G-B222,171 Meeting St Providence RI USA 02912 SA
Citazione:
A. Sgadari et al., "Oxidative and nonoxidative benzodiazepines and the risk of femur fracture", J CL PSYCH, 20(2), 2000, pp. 234-239

Abstract

Benzodiazepine use is a well-identified risk factor for falls and the resulting femur fractures in elderly adults. Benzodiazepines not requiring hepatic biotransformation may be safer than agents undergoing oxidation becauseoxidative activity has been shown to decline with age. The association between the use of either oxidative or nonoxidative benzodiazepines and the risk of femur fracture among elderly adults Living in nursing homes was studied. A nested case-control study was conducted using the Systematic Assessment of Geriatric drug use via Epidemiology (SAGE) database; the records of 9,752 patients hospitalized for incident femur fracture during the period 1992 to 1996 mere extracted, matching by age, gender, state, and index date to the records of 38,564 control patients. Conditional logistic regression models were conducted to estimate the odds ratios (ORs) for femur fracture with adjustment for potential confounders. The adjusted OR for the overall use of benzodiazepines mas 1.10 (95% confidence interval [CI], 0.98-1.20); the risk seemed of only slightly greater magnitude for exposure to nonoxidative agents (1.18; 95% CI, 1.03-1.36) than to oxidative benzodiazepines (1.08; 95%, CI, 0.95-1.23). Among the latter, the effect nas mainly accounted for by the use of agents with a long elimination half-life. A dose relationship was observed exclusively among users of long half-life oxidative benzodiazepines. The risk associated with the use of nonoxidative benzodiazepinesshowed no relationship to the age of the patients. In contrast, patients aged 85 years or older receiving oxidative benzodiazepines at high dosages or as needed had a two- to three-fold increased risk of femur fracture than did patients in the younger age group, Among older individuals, the use of benzodiazepines slightly increased the risk of femur fracture, mainly irrespective of the metabolic fate of the drug. Our results suggest that the useof nonoxidative benzodiazepines does not carry a lower risk for femur fracture than does the use of oxidative benzodiazepines. However, the latter agents may be associated with a somewhat higher risk of side effects among the oldest old, especially at higher dosages.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 07:19:33