rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2016-12-4-471-478rpcardio-1313Research ArticleCURRENT QUESTIONS OF CLINICAL PHARMACOLOGYАКТУАЛЬНЫЕ ВОПРОСЫ КЛИНИЧЕСКОЙ ФАРМАКОЛОГИИAntiarrhythmic drugs use in elderly patients. Vaughan Williams class I and II drugsПРИМЕНЕНИЕ АНТИАРИТМИЧЕСКИХ СРЕДСТВ У ПОЖИЛЫХ ПАЦИЕНТОВ. ПРЕПАРАТЫ I И II КЛАССА ПО КЛАССИФИКАЦИИ ВОГАНА-ВИЛЬЯМСАУшкаловаЕ. А.UshkalovaE. A.

д.м.н., профессор кафедры общей и клинической фармакологии,

117198, Москва, ул. Миклухо-Маклая, 6

Miklukho-Maklaya ul. 6, Moscow, 117198

eushk@yandex.ruЗыряновС. К.ZyryanovS. K.

д.м.н., зав. кафедрой общей и клинической фармакологии,

117198, Москва, ул. Миклухо-Маклая, 6

Miklukho-Maklaya ul. 6, Moscow, 117198

ЗатолочинаК. Э.ZatolochinaK. E.

к.м.н., ассистент кафедры общей и клинической фармакологии,

117198, Москва, ул. Миклухо-Маклая, 6

Miklukho-Maklaya ul. 6, Moscow, 117198

ПереверзевА. П.PereverzevA. P.

к.м.н., доцент кафедры общей и клинической фармакологии,

117198, Москва, ул. Миклухо-Маклая, 6

Miklukho-Maklaya ul. 6, Moscow, 117198

ЧухареваН. А.ChukharevaN. A.

м.н.с. терапевтического отделения,

117997, Москва, ул. Опарина, 4

Oparina ul. 4, Moscow, 117997

Российский университет дружбы народовРоссияPeople's Friendship University of RussiaRussian FederationНаучный центр акушерства, гинекологии и перинатологии им. академика В.И. КулаковаРоссияScientific Center for Obstetrics, Gynecology and Perinatology named after Academician V.I. KulakovRussian Federation201611092016124471478Copyright © Ushkalova E.A., Zyryanov S.K., Zatolochina K.E., Pereverzev A.P., Chukhareva N.A., 20162016Ушкалова Е.А., Зырянов С.К., Затолочина К.Э., Переверзев А.П., Чухарева Н.А.Ushkalova E.A., Zyryanov S.K., Zatolochina K.E., Pereverzev A.P., Chukhareva N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/1313

Use of class I antiarrhythmic drugs in the elderly is limited by their adverse drug reactions (ADRs), proarrhythmic effect (I A и I C) and high risk of drug interactions. Disopyramide use should be avoided due to its strong anticholinergic properties associated with the risk of cognitive and physical disorders and falls in the “very elderly” patients. Available data suggest that elderly patients do not have significant limitations for beta-blockers use. However to determine beta-blockers with the best benefit/risk ratio in elderly patients with co-morbidity further clinical trials are needed.

Применение антиаритмических препаратов I класса у пожилых пациентов ограничивают их нежелательные реакции, аритмогенное действие (I A и I C) и высокий риск лекарственных взаимодействий. Применения дизопирамида следует избегать из-за выраженных антихолинергических свойств, сопряженных с риском развития когнитивных и соматических расстройств и падений у самых пожилых пациентов. Имеющиеся данные позволяют предположить, что у пожилых лиц нет существенных ограничений к применению β-адреноблокаторов. Однако для определения препаратов данной группы с оптимальным соотношением польза/риск у лиц пожилого возраста с коморбидностью необходимы дальнейшие исследования.

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