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Pharmacology > Pharmacology in Special Populations - Geriatrics > Flashcards

Pharmacology in Special Populations - Geriatrics Flashcards

1
Q

What age is considered elderly in society and in medicine?

A

society = 65
medicine = 75

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2
Q

Organ function declines progressively beginning around the (…) decade of life but seems to be dependent on overall “health”

A

3rd (in your thirties)

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3
Q

In patients 65+ years old, glomerular function (…)

A

decreases

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4
Q

Who will have better breathing capacities?

A

active, aerobic people

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5
Q

What are some pharmacokinetic concepts you need to consider with geriatric patients?

A
  • absorption
  • distribution
  • metabolism
  • elimination
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6
Q

In elderly patients, skin is (…)

A

thinner

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7
Q

Elderly patients have (…) stomach acid

A

reduced

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8
Q

Elderly patients have (…) gastric emptying, especially in diabetes

A

slower

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9
Q

Elderly patients have changes in nutrition so they may not what?

A

be eating as much as you think

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10
Q

Because skin is thinner in the elderly, absorption of drugs may be (…)

A

quicker and will absorb more medications in the skin

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11
Q

Because stomach acid(pH) is reduced in elderly patients, what may happen?

A

pts may experience higher peak plasma concentrations

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12
Q

Because gastric emptying is slower in elderly patients, what may happen?

A

drugs will sit in the stomach longer, decreasing the rate of absorption

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13
Q

Elderly patients have (1) muscle mass and (2) body fat percentage

A
  1. less
  2. greater
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14
Q

Elderly patients have (1) albumin and (2) alpha-acid glycoprotein

A
  1. lower
  2. higher
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15
Q

Elderly patients have (…) body water

A

lower

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16
Q

Having a higher alpha-acid glycoprotein can increase what?

A

protein binding

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17
Q

Low nutrition and reduced liver function leads to (…)

A

lower albumin

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18
Q

Less muscle mass, greater body fat percentage, albumin levels, glycoprotein levels, and body water all affects what?

A

volume of distribution

19
Q

Does low albumin levels increase or decrease volume of distribution?

A

increase

20
Q

Does lower body water increase of decrease volume of distribution?

A

decrease

21
Q

Does less muscle mass increase or decrease volume of distribution?

A

decrease

22
Q

In elderly patients, blood flow to the liver (…), which is exacerbated by congestive heart failure

A

decreases

23
Q

Decreases in blood flow to the liver as you get older can lead to drugs doing what?

A

not moving through the body well

24
Q

In elderly patients, phase I reactions (…)

A

decrease

25
Q

What may be present in elderly patients and is important in metabolism of drugs even if resolved because there may still be residual damage?

A

liver damage

26
Q

What may malnutrition affect in elderly patients?

A

drug metabolism

27
Q

What are 3 ways that drug elimination is affected in elderly patients?

A
  1. decrease in GFR
  2. dehydration
  3. reduced lung capacity
28
Q

A decrease in GFR may indicate what?

A

the kidneys are not functioning as they should (decrease in functionality)

29
Q

How does dehydration affect drug elimination?

A

decreases drug elimination

30
Q

Reduced lung capacity and prevalence of pulmonary disease limit what?

A

the use of inhaled anesthetics

31
Q

Almost all elderly pts have some form of (…)

A

diabetes

32
Q

What are 4 additional drug problems that elderly patients may have to deal with?

A
  1. multiple drugs, multiple doctors
  2. cost
  3. access to care
  4. physical problems leading to inability to use medications properly
33
Q

What may multiple drugs and multiple doctors lead to in elderly patients?

A
  • side effects
  • interactions
  • poor compliance
  • duplicate therapies
34
Q

“New” symptoms in older adults should be considered a (…) and a thorough drug history should be obtained and sorted through

A

medication side effect

35
Q

Patients in a facility where drugs are administered to them may have what happen to them?

A

may not be receiving their medications on time

36
Q

“Child proof” medication bottles might also be what?

A

elder proof

37
Q

What are some ways in which physical problems may lead to elderly patients not using medications properly?

A
  • may not be able to open containers
  • may get confused which pill is which
  • may take pill at wrong time, thinking it is something else
38
Q

What is Beers Criteria for potentially inappropriate medication use in older patients?

A
  • list of drugs to avoid or use with caution in patients over 65
39
Q

What does Beers Criteria not apply to?

A

hospice or palliative care

40
Q

Beers Criteria’s concerns often apply to?

A
  • fall risks
  • seizure risks
  • cognitive impairment
  • renal function
41
Q

What are some strategies to improve therapeutic outcomes in older adults?

A
  • thorough drug history
  • watch off-label prescribing
  • start low and go slow
  • know your side effects and drug interactions
  • use simple regimens
  • make sure the patient understands the directs and is able to follow them
  • consider expected life span of patient
  • discuss patient goals and willingness to comply
42
Q

What is off-label prescribing?

A

prescribing a drug for a different purpose than what the FDA approved

43
Q

Why would you start at a low dose and go slow in treating elderly patients?

A

you want to make sure drugs work well and don’t have side-effects
wait 3 half-lives, maybe 5 in elderly

44
Q

Why should you consider expected life span of a patient when prescribing medications?

A

quality of life matters, medications may decrease the quality of life, so patient may not want to take the medication

Pharmacology (13 decks)

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