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Flashcards in 5 - Aging Pharm Deck (6):
1

how does age change drugs binding to protein?

inc free fraction of some highly bound acidic drugs
albumin normal in health, but may drop rapidly w/ illness > inc free conc of lots of drugs
alpha-1-acid glycoprotein inc w/ age, up further w/ illness > binds more antidepressants

2

phenytoin conc in elderly

twice as much is free in older people, so let total level be half as much as in adults as long as they are seizure free

3

which CYP450 complex is most used by drugs on market?

CYP3A4 (things you can't take grapefruit juice with use this enzyme)

4

first pass effect and old people

old people are slower at metabolizing > less first pass effect > inc effective dose more in old person than young person when you double dose

5

Cockroft Gault Eqn

estimates renal function
CLcr = (140-age)*IBW/(SCr*72)
(x0.85 if female)
really shitty for old people

6

MC sx from drug interactions

hypoTN /orthostatic changes
acute renal failure
confusion
cognitive impairment