転倒・骨折に影響する薬剤

Fall Risk and Fracture. Drugs that affect the fall or fracture.

　睡眠薬の服用と転倒の関連を調べた結果，転倒率は超短時間型のマイスリー®錠（ゾルピデム）が1.6％と短時間作用型の5.0～6.8％に比べ低かった。転倒例はマイスリー®錠の服用では昼間と夜間で同等であったのに対し，短時間作用型の服用では昼間に多く，持ち越し効果が一因と考えられた。そこで，転倒の防止策として，マイスリー®錠を優先的に処方するようにした結果，睡眠薬の服用患者における転倒患者数は減少した。睡眠薬は転倒後の状況にも影響しており，重症化リスクはマイスリー®錠を1とした場合，デパス®錠（エチゾラム）は48，ロヒプノール®錠（フルニトラゼパム）は38とリスクが高かった。

　The relationship between the fall and types of hypnotics was studied. The incidence of falls on hypnotics was lower in subjects on ultra-short-acting type, such as Myslee tablet（1.6％）than in those on short-acting type（5.0 to 6.8％）drugs. For Myslee tablet, the incidences were similar in the daytime and the nighttime, but for short-acting hypnotics, the incidence was higher in the daytime than in the nighttime, suggesting a persistent diurnal effect. In order to prevent falls, we recommend to physicians prescribe Myslee tablet whenever possible. Afterwards, the number of patients who experienced falls decreased by 40％. 　The hypnotics was effected the severity of the injury after falling down. The odds ratios of different types of hypnotics to Myslee tablet on severe injury after falling as follows：Depas tablet having the highest odds ratioat 48, Rohypnol tablet coming in second at 38, respectively.