Flashcards in 5 - Aging Pharm Deck (6):
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
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
which CYP450 complex is most used by drugs on market?
CYP3A4 (things you can't take grapefruit juice with use this enzyme)
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
Cockroft Gault Eqn
estimates renal function
CLcr = (140-age)*IBW/(SCr*72)
(x0.85 if female)
really shitty for old people