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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


MC sx from drug interactions

hypoTN /orthostatic changes
acute renal failure
cognitive impairment