Medikamentöse Therapie bei Frauen – Was gilt es zu beachten?

Clinical Research in Cardiology Supplements - Tập 8 Số 1 - Trang 32-37 - 2013
Ravens, Ursula1
1Institut für Pharmakologie und Toxikologie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

Tóm tắt

Frauen und Männer unterscheiden sich in ihren Reaktionen gegenüber Medikamenten. Geschlechtsabhängige pharmakokinetische Unterschiede betreffen vorwiegend die Metabolisierungsgeschwindigkeit und Verteilung von Arzneistoffen, meist sind die Plasmaspiegel bei Frauen höher als bei Männern. Das Risiko für Frauen, unerwünschte Arzneimittelwirkungen zu erleiden, ist signifikant größer als für Männer. Die Geschlechtsabhängigkeit der medikamentösen Therapie hat vielerlei Gründe, sie weist deutlich auf die Notwendigkeit hin, dass die biologischen Unterschiede zwischen Männern und Frauen bei der Pharmakotherapie gezielt untersucht und möglichst auch in den Leitlinien berücksichtigt werden müssen.

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citation_journal_title=N Engl J Med; citation_title=Enrollment of women in cardiovascular clinical trials funded by the national heart, lung, and blood institute; citation_author=DJ Harris, PS Douglas; citation_volume=343; citation_publication_date=2000; citation_pages=475-480; citation_doi=10.1056/NEJM200008173430706; citation_id=CR1 citation_journal_title=Clin Pharmacol Ther; citation_title=Underrepresentation of women in clinical drug trials; citation_author=DL Schmucker, ES Vesell; citation_volume=54; citation_publication_date=1993; citation_pages=11-15; citation_doi=10.1038/clpt.1993.102; citation_id=CR2 citation_journal_title=Nature; citation_title=Sex bias in trials and treatment must end; citation_author=AM Kim, CM Tingen, TK Woodruff; citation_volume=465; citation_publication_date=2010; citation_pages=688-689; citation_doi=10.1038/465688a; citation_id=CR3 citation_journal_title=JAMA; citation_title=Vitamin E in the primary prevention of cardiovascular disease and cancer: the women’s health study: a randomized controlled trial; citation_author=IM Lee, NR Cook, JM Gaziano, D Gordon, PM Ridker, JE Manson, CH Hennekens, JE Buring; citation_volume=294; citation_publication_date=2005; citation_pages=56-65; citation_doi=10.1001/jama.294.1.56; citation_id=CR4 citation_journal_title=JAMA; citation_title=Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the women’s health initiative randomized controlled trial; citation_author=JE Rossouw, GL Anderson, RL Prentice, AZ LaCroix, C Kooperberg, ML Stefanick, RD Jackson, SA Beresford, BV Howard, KC Johnson, JM Kotchen, J Ockene; citation_volume=288; citation_publication_date=2002; citation_pages=321-333; citation_doi=10.1001/jama.288.3.321; citation_id=CR5 citation_journal_title=Ann Pharmacother; citation_title=Risk factors for adverse drug events: a 10-year analysis; citation_author=RS Evans, JF Lloyd, GJ Stoddard, JR Nebeker, MH Samore; citation_volume=39; citation_publication_date=2005; citation_pages=1161-1168; citation_doi=10.1345/aph.1E642; citation_id=CR6 citation_journal_title=Am J Clin Dermatol; citation_title=Do women have more adverse drug reactions?; citation_author=M Rademaker; citation_volume=2; citation_publication_date=2001; citation_pages=349-351; citation_doi=10.2165/00128071-200102060-00001; citation_id=CR7 citation_journal_title=J Womens Health (Larchmt); citation_title=Sex and racial differences in pharmacological response: where is the evidence? Pharmacogenetics, pharmacokinetics, and pharmacodynamics; citation_author=GD Anderson; citation_volume=14; citation_publication_date=2005; citation_pages=19-29; citation_doi=10.1089/jwh.2005.14.19; citation_id=CR8 citation_journal_title=Clin Pharmacokinet; citation_title=The influence of sex on pharmacokinetics; citation_author=JB Schwartz; citation_volume=42; citation_publication_date=2003; citation_pages=107-121; citation_doi=10.2165/00003088-200342020-00001; citation_id=CR9 citation_journal_title=Clin Pharmacokinet; citation_title=Sex differences in pharmacokinetics and pharmacodynamics; citation_author=OP Soldin, DR Mattison; citation_volume=48; citation_publication_date=2009; citation_pages=143-157; citation_doi=10.2165/00003088-200948030-00001; citation_id=CR10 citation_journal_title=Int Rev Neurobiol; citation_title=Gender differences in pharmacological response; citation_author=GD Anderson; citation_volume=83; citation_publication_date=2008; citation_pages=1-10; citation_doi=10.1016/S0074-7742(08)00001-9; citation_id=CR11 citation_journal_title=Clin Pharmacol Ther; citation_title=Pharmacokinetic analysis of bioequivalence trials: implications for sex-related issues in clinical pharmacology and biopharmaceutics; citation_author=ML Chen, SC Lee, MJ Ng, DJ Schuirmann, LJ Lesko, RL Williams; citation_volume=68; citation_publication_date=2000; citation_pages=510-521; citation_doi=10.1067/mcp.2000.111184; citation_id=CR12 citation_journal_title=Hepatology; citation_title=Sex is a major determinant of CYP3A4 expression in human liver; citation_author=R Wolbold, K Klein, O Burk, AK Nussler, P Neuhaus, M Eichelbaum, M Schwab, UM Zanger; citation_volume=38; citation_publication_date=2003; citation_pages=978-988; citation_id=CR13 citation_journal_title=J Clin Pharmacol; citation_title=Gender-specific effects on verapamil pharmacokinetics and pharmacodynamics in humans; citation_author=ME Krecic-Shepard, CR Barnas, J Slimko, MP Jones, JB Schwartz; citation_volume=40; citation_publication_date=2000; citation_pages=219-230; citation_doi=10.1177/00912700022008883; citation_id=CR14 citation_journal_title=Clin Pharmacol Ther; citation_title=Race and sex influence clearance of nifedipine: results of a population study; citation_author=ME Krecic-Shepard, K Park, C Barnas, J Slimko, DR Kerwin, JB Schwartz; citation_volume=68; citation_publication_date=2000; citation_pages=130-142; citation_doi=10.1067/mcp.2000.108678; citation_id=CR15 citation_journal_title=Clin Pharmacol Ther; citation_title=Gender-related effects on metoprolol pharmacokinetics and pharmacodynamics in healthy volunteers; citation_author=AB Luzier, A Killian, JH Wilton, MF Wilson, A Forrest, DJ Kazierad; citation_volume=66; citation_publication_date=1999; citation_pages=594-601; citation_id=CR16 citation_journal_title=Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz; citation_title=Gender-related differences in pharmacokinetics and pharmacodynamics; citation_author=PA Thurmann; citation_volume=48; citation_publication_date=2005; citation_pages=536-540; citation_doi=10.1007/s00103-005-1039-0; citation_id=CR17 citation_journal_title=Clin Pharmacol Ther; citation_title=Biologic determinants of propranolol disposition: results from 1308 patients in the beta-blocker heart attack trial; citation_author=T Walle, RP Byington, CD Furberg, KM McIntyre, PS Vokonas; citation_volume=38; citation_publication_date=1985; citation_pages=509-518; citation_doi=10.1038/clpt.1985.216; citation_id=CR18 citation_journal_title=Clin Pharmacokinet; citation_title=How important are gender differences in pharmacokinetics?; citation_author=B Meibohm, I Beierle, H Derendorf; citation_volume=41; citation_publication_date=2002; citation_pages=329-342; citation_doi=10.2165/00003088-200241050-00002; citation_id=CR19 citation_journal_title=Clin Pharmacol Ther; citation_title=The current state of knowledge on age, sex, and their interactions on clinical pharmacology; citation_author=JB Schwartz; citation_volume=82; citation_publication_date=2007; citation_pages=87-96; citation_doi=10.1038/sj.clpt.6100226; citation_id=CR20 citation_journal_title=JAMA; citation_title=Association of serum digoxin concentration and outcomes in patients with heart failure; citation_author=SS Rathore, JP Curtis, Y Wang, MR Bristow, HM Krumholz; citation_volume=289; citation_publication_date=2003; citation_pages=871-878; citation_doi=10.1001/jama.289.7.871; citation_id=CR21 citation_journal_title=Clin Pharmacokinet; citation_title=Physiological changes during the menstrual cycle and their effects on the pharmacokinetics and pharmacodynamics of drugs; citation_author=AD Kashuba, AN Nafziger; citation_volume=34; citation_publication_date=1998; citation_pages=203-218; citation_doi=10.2165/00003088-199834030-00003; citation_id=CR22 citation_journal_title=Clin J Pain; citation_title=Sex differences in opioid analgesia: „from mouse to man“; citation_author=RM Craft; citation_volume=19; citation_publication_date=2003; citation_pages=175-186; citation_doi=10.1097/00002508-200305000-00005; citation_id=CR23 citation_journal_title=Acta Anaesthesiol Scand; citation_title=Gender differences in drug effects: implications for anesthesiologists; citation_author=H Pleym, O Spigset, ED Kharasch, O Dale; citation_volume=47; citation_publication_date=2003; citation_pages=241-259; citation_doi=10.1034/j.1399-6576.2003.00036.x; citation_id=CR24 citation_journal_title=J Neurosci; citation_title=mu-opioid receptor-mediated antinociceptive responses differ in men and women; citation_author=JK Zubieta, YR Smith, JA Bueller, Y Xu, MR Kilbourn, DM Jewett, CR Meyer, RA Koeppe, CS Stohler; citation_volume=22; citation_publication_date=2002; citation_pages=5100-5107; citation_id=CR25 citation_journal_title=Am J Psychiatry; citation_title=Gender differences in treatment response to sertraline versus imipramine in chronic depression; citation_author=SG Kornstein, AF Schatzberg, ME Thase, KA Yonkers, JP McCullough, GI Keitner, AJ Gelenberg, SM Davis, WM Harrison, MB Keller; citation_volume=157; citation_publication_date=2000; citation_pages=1445-1452; citation_doi=10.1176/appi.ajp.157.9.1445; citation_id=CR26 citation_journal_title=N Engl J Med; citation_title=Sex-based differences in the effect of digoxin for the treatment of heart failure; citation_author=SS Rathore, Y Wang, HM Krumholz; citation_volume=347; citation_publication_date=2002; citation_pages=1403-1411; citation_doi=10.1056/NEJMoa021266; citation_id=CR27 citation_journal_title=Mol Interv; citation_title=Sex, digitalis, and the sodium pump; citation_author=MP Blaustein, SW Robinson, SS Gottlieb, CW Balke, JM Hamlyn; citation_volume=3; citation_publication_date=2003; citation_pages=68-72; citation_doi=10.1124/mi.3.2.68; citation_id=CR28 citation_journal_title=N Engl J Med; citation_title=The puzzle of aspirin and sex; citation_author=RI Levin; citation_volume=352; citation_publication_date=2005; citation_pages=1366-1368; citation_doi=10.1056/NEJMe058051; citation_id=CR29 citation_journal_title=N Engl J Med; citation_author=; citation_volume=321; citation_publication_date=1989; citation_pages=129-135; citation_id=CR30 citation_journal_title=N Engl J Med; citation_title=A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women; citation_author=PM Ridker, NR Cook, IM Lee, D Gordon, JM Gaziano, JE Manson, CH Hennekens, JE Buring; citation_volume=352; citation_publication_date=2005; citation_pages=1293-1304; citation_doi=10.1056/NEJMoa050613; citation_id=CR31 citation_journal_title=Trends Pharmacol Sci; citation_title=Gender differences in drug toxicity; citation_author=TJ Nicolson, HR Mellor, RR Roberts; citation_volume=31; citation_publication_date=2010; citation_pages=108-114; citation_doi=10.1016/j.tips.2009.12.001; citation_id=CR32 citation_journal_title=Int J Toxicol; citation_title=Gender-based differences in the toxicity of pharmaceuticals – the food and drug administration’s perspective; citation_author=MA Miller; citation_volume=20; citation_publication_date=2001; citation_pages=149-152; citation_doi=10.1080/109158101317097728; citation_id=CR33 citation_journal_title=Eur J Clin Pharmacol; citation_title=Women encounter ADRs more often than do men; citation_author=Y Zopf, C Rabe, A Neubert, KG Gassmann, W Rascher, EG Hahn, K Brune, H Dormann; citation_volume=64; citation_publication_date=2008; citation_pages=999-1004; citation_doi=10.1007/s00228-008-0494-6; citation_id=CR34 citation_journal_title=Br J Clin Pharmacol; citation_title=Age and sex distribution of suspected adverse drug reactions to newly marketed drugs in general practice in England: analysis of 48 cohort studies; citation_author=RM Martin, PN Biswas, SN Freemantle, GL Pearce, RD Mann; citation_volume=46; citation_publication_date=1998; citation_pages=505-511; citation_doi=10.1046/j.1365-2125.1998.00817.x; citation_id=CR35 citation_journal_title=Drug Saf; citation_title=Is gender a risk factor for adverse drug reactions? The example of drug-induced long QT syndrome; citation_author=MD Drici, N Clement; citation_volume=24; citation_publication_date=2001; citation_pages=575-585; citation_doi=10.2165/00002018-200124080-00002; citation_id=CR36 citation_journal_title=JAMA; citation_title=Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs; citation_author=RR Makkar, BS Fromm, RT Steinman, MD Meissner, MH Lehmann; citation_volume=270; citation_publication_date=1993; citation_pages=2590-2597; citation_doi=10.1001/jama.1993.03510210076031; citation_id=CR37 citation_journal_title=Pharmacol Ther; citation_title=Drugs for men and women – how important is gender as a risk factor for TdP?; citation_author=SJ Coker; citation_volume=119; citation_publication_date=2008; citation_pages=186-194; citation_doi=10.1016/j.pharmthera.2008.03.005; citation_id=CR38 citation_journal_title=Pharmacol Ther; citation_title=Gender disparity in cardiac electrophysiology: implications for cardiac safety pharmacology; citation_author=MK Jonsson, MA Vos, G Duker, S Demolombe, TA van Veen; citation_volume=127; citation_publication_date=2010; citation_pages=9-18; citation_doi=10.1016/j.pharmthera.2010.04.002; citation_id=CR39 citation_journal_title=Circulation; citation_title=Sex differences in major bleeding with glycoprotein IIb/IIIa inhibitors: results from the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) initiative; citation_author=KP Alexander, AY Chen, LK Newby, JB Schwartz, RF Redberg, JS Hochman, MT Roe, WB Gibler, EM Ohman, ED Peterson; citation_volume=114; citation_publication_date=2006; citation_pages=1380-1387; citation_doi=10.1161/CIRCULATIONAHA.106.620815; citation_id=CR40 citation_journal_title=Pharm World Sci; citation_title=Hospitalisations caused by adverse drug reactions (ADR): a meta-analysis of observational studies; citation_author=HJ Beijer, CJ de Blaey; citation_volume=24; citation_publication_date=2002; citation_pages=46-54; citation_doi=10.1023/A:1015570104121; citation_id=CR41 citation_journal_title=JAMA; citation_title=Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies; citation_author=J Lazarou, BH Pomeranz, PN Corey; citation_volume=279; citation_publication_date=1998; citation_pages=1200-1205; citation_doi=10.1001/jama.279.15.1200; citation_id=CR42 citation_journal_title=BMJ; citation_title=Adverse drug reactions as cause of admission to hospital: prospective analysis of 18,820 patients; citation_author=M Pirmohamed, S James, S Meakin, C Green, AK Scott, TJ Walley, K Farrar, BK Park, AM Breckenridge; citation_volume=329; citation_publication_date=2004; citation_pages=15-19; citation_doi=10.1136/bmj.329.7456.15; citation_id=CR43 citation_journal_title=Br J Clin Pharmacol; citation_title=Incidence of fatal adverse drug reactions: a population based study; citation_author=K Wester, AK Jonsson, O Spigset, H Druid, S Hagg; citation_volume=65; citation_publication_date=2008; citation_pages=573-579; citation_doi=10.1111/j.1365-2125.2007.03064.x; citation_id=CR44 citation_journal_title=Br J Clin Pharmacol; citation_title=Sex-related differences in hospital admissions attributed to adverse drug reactions in the Netherlands; citation_author=EM Rodenburg, BH Stricker, LE Visser; citation_volume=71; citation_publication_date=2011; citation_pages=95-104; citation_doi=10.1111/j.1365-2125.2010.03811.x; citation_id=CR45 citation_journal_title=Z Evid Fortbild Qual Gesundhwes; citation_title=Gender: new methodological approaches in guideline development; citation_author=S Weinbrenner, S Lonnfors, B Babitsch; citation_volume=104; citation_publication_date=2010; citation_pages=547-553; citation_doi=10.1016/j.zefq.2010.08.001; citation_id=CR46