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micro/immuno? wrap up > ADEs of old ppl drugs > Flashcards

ADEs of old ppl drugs Flashcards

1
Q

constipation = new symtom

what is the drug responsible?

A

narcotics

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2
Q

renal failure, hearing loss =new symtom

what is the drug responsible?

A

aminoglycosides

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3
Q

new symptom = dry mouth, constipatio, urinary retention, and deliriumtom

what is the drug responsible?

A

anticholinergic

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4
Q

diarrhea(quinidine); urinary retetion(disopyramide) = new symtom

what is the drug responsible?

A

antiarrhythmics

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5
Q

dehydration, hyponatremia, hypokalemia, incontience = new symtom

what is the drug responsible?

A

diuretics

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6
Q

delirium, sedation, hypotension, extrapyramidal disorders=new symtom

what is the drug responsible?

A

antipsychotics

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7
Q

excessivve sedation, delirium, gait disturbance=new symtom

what is the drug responsible?

A

sedative-hypnotic

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8
Q

interference w/drug absorption

A

antacid

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9
Q

polypharmacy: drug-drug interaction
consequence: protein binding displacemen
ex: oral hypoglycemics, aspirin, chloral hydrate

A

warfarin

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10
Q

consequence: altered metabolism
affects: propanoll

theophylline

phenytoin

A

cimetidine

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11
Q

altered extrection

drug inovlved: lithium

A

diuretics

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12
Q

consdquence = increased bioavilability;

drugs: dextromethorpham, midazolam, imatinb

culprit?

A

grape fruit juice = CYP inducer

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13
Q

disease: dementia

**drug: **

**ADE: 2 **

A

drug: psychotropics

ADE: confusion and delirium

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14
Q

disease: glaucoma

drug:

ADE:

A

drug: antimuscarinic

ADE: acute glaucoma

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15
Q

disease: CHF
drug: 2

ADE:

A

beta blockers, and verapamil = drugs

ADE: acute decompression

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16
Q

disease: conduction disordrs
drug:

ADE:

A

DRug: TCAs

ADE: heart block

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17
Q

disease: HTN
drug:

ADE:

A

drug: NSAIDs
effect: increase BP

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18
Q

disease: peripheral vascular disease
drug:

ADE:

A

drug: beta blockers
effect: intermittend claudication

19
Q

disease: COPD
drug:

ADE:

A

drug: beta blockers

ADE: brochoconstriction

20
Q

disease: chronic renal impairment
drug: 3

ADE:

A

disease:
drug: NSAIDs, contrast, aminoglycosides

ADE: acute renal failure

21
Q

disease: DM
drug: 2

ADE:

A

disease:
drug: diuretics, prednisone(cortisol enchanes gluconeogenesis)

ADE: hyperglycemia

22
Q

disease: BPH
drug:

ADE:

A

disease:
drug: antimuscarinic agents

ADE: urinary retention

23
Q

disease: depression
drug: 5

ADE:

A

drugs: beta blcokers, central antihypertensives, alochol, benzos, steroids
effect: precipitation or exacerbation of depression

24
Q

disease: hypokalemia
drug:

ADE:

A

disease:
drug: digoxin

ADE: cardiac arrhythmias

25
Q

PUD

disease: Peptic ulcer disease
drug: 2

ADE:

A

disease:
drug: NSAIDs, anticoagulant

ADE: GI hemorrhage

26
Q

what are the 7 classes of drugs with strong anti-cholinergic activity

A

Anti-histamine

Anti-parkisnonia

skeletal muscle relexants,

antimuscarinics - urinary incontinence

anti-depresants

anti-psychotics

27
Q

condition: dysrhtymia

high risk med(s):

effect:

A

condition:

high risk med(s): TCAs

effect: prolonged QT

28
Q

condition: COPD

high risk med(s): 2

effect:

A

condition:

high risk med(s): beta blockers, long acting benzodiazepines

effect: respiratory depression

29
Q

condition: heart failure

high risk med(s): 2

effect:

A

condition

meds:

inotrope effects(disopyramide), drugs with high Na+ content(bisphosphanate, citrate, salicylate)

effect: fluid retention, increase heart failure

30
Q

condition: chronic constipation

high risk meds: 2

effect:

A

high risk meds: CCBs, anticholinergics

effect: increase constpation, impaction, obstruction

31
Q

condition: hyponatremia

high risk med:

effect:

A

condition:

high risk med: SSRI

effect: hyponatremia

32
Q

condition: orthostatic hypotension

high risk med: 3

effect:

A

condition:

high risk med: diuretics, alpha blockers, vasodilators

effect: near syncope, syncope falling–>potential for injury

33
Q

3 drug classes with high Beers criteria

A

anxiolytics

anti-depressants

sedative-hypnotics

also at risk for: addition, abuse, oversedation, respiratory depressin, confusion

34
Q

many old ppl on benzos will become dependent and sudden termination –>emergence of withdrawal symptoms.

which two short acting benzos should be used?

A

alprazolam

temazepam

lorazepam

35
Q

which anti-depressant with strong anti-cholinergic and sedative properties should be avoided in old ppl?

A

amitriptyline

36
Q

which depression drugs are safer for older ppl with a decreased riks for cardiotox, orthostatic hypotension, and anticholinergic effects?

A

SSRIs (citalopram, escitalopram)

37
Q

which anti-arrhythmic drug in C/I in older patients by BEERS criteria b/c of significant anticholinergic properties?

IT can induce heart block especially in patients with congestive heart failure.

A

DISOPYRAMIDE

38
Q

according to BEERS criteria, 33% of ED visits in geriatric pts were due to an ADE of: (3 drugs here IDW)

A

Insulin

warfarin

digoxin

39
Q

comment: although appropriate, aggresssive glycemic control may be harmful

potential harm:

drug:

A

potential harm: hypoglycemia

drug: insulin and sulfonylureas (CYP and plasma protein binding)

40
Q

potential harm: GI and intracranial bleeding

comment: altough a risk drug, careful control of INR in therapeutic range tightly linked to risk/benefit ratio

A

drug: WARFARIN!! (S-warfarin & CYP2C9)
note: S-warfarin = 2-5x more potent

41
Q

drug:

potential harm: impaired cognition and heart block

comment; may have 3rd line role in systolic heart failure, suboptimal choice for rate control in atrial fibrillation

A

drug: digoxin

potential harm: i

42
Q

what does the mnemonic MASTER stand for?

start low, go slow

add one, take one away

A

M- minimize the number of drugs used

A- alternatives should always be considered, especially non-drug therapies

S-start low, go slow

T- titrate therapy; adjust dose on an individual basis

E- educate the pt and family; provide clear writen instructions

R- review regularyy - remember that the older paiten will need closer monitoring

43
Q

which 3 drug classes will caused SIADH in old ppl?

VPS

A

vinka alkaloids

sulfonylureas

psychotropics (SSRIs, TCA, haloperidol)

44
Q

what disease would most likely give rise to orthostatic hypotension in an elderly patient?

A

diabetes. why?
think: peripheral neuropathy –> alpha receptors on vasculature unable to respond to decrease in BP

micro/immuno? wrap up (14 decks)

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