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Y3 Ageing > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Acidic drugs need an _____ environment for absorption

A

Acidic

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2
Q

The stomach in elderly people is more _____ compared to the general population

A

Basic

Due to less gastric parietal cells that secrete HCl

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3
Q

Drug distribution: acidic drugs bind to _____

A

Albumin

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4
Q

Sacropenia causes increased fat with increases the _____ of _____ drugs. This increases their half life such as diazepam

A

Volume of distribution

Lipophilic

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5
Q

Lithium and digoxin are ____ so have a ____ half life and stay in the plasma

A

Lithium and digoxin are HYDROPHILIC so have a SHORT half life and stay in the plasma

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6
Q

Why is 1st pass metabolism different in elderly people compared to the general population?

A

Physiological decreased liver function

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7
Q

Why is drug excretion different in elderly people compared to the general population?

A

Physiological decrease in GFR

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8
Q

A lower therapeutic index causes ….

A

Increased toxicity

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9
Q

Generally in older people, lower doses have the same effect except which drug class which effects HR?

A

Beta-blockers

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10
Q

What do theophylline, warfarin, lithium, digoxin, genta, vanco, phenytoin, cyclosporin, carbamazepine and levothyroxine all have in common?

A

Low therapeutic index

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11
Q

Anticholinergic SEs

A 
Dry mouth (dry as a bone)
Confusion / hallucinations (mad as a hatter)
Tachycardia (flappy as a bird)
Retention (stuffed as a pipe)
Constipation (stuffed as a pipe)
Blurred vision (blind as a bat)
Dizzy 
Plethora (red as a beet)
Hot as a hare
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12
Q

What are the SEs of gabapentin in older people?

A

Dizzy
Fatigue
Vision
Confusion

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13
Q

Amlodipine main SE

A

Ankle edema

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14
Q

What drug should be given to people over 80 on an antiplatelet or SSRI?

A

PPI

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15
Q

What drug should be co-administered with opioids in elderly people and why?

A

Lactulose / senna

Constipation prophylaxis

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16
Q

What drug should be given instead of NSAIDs for mild OA Mx in the elderly? And why?

A

Paracetamol

Since lowered GFR and increased risk GI haemorrhage

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17
Q

What is the WHO pain ladder?

A

NSAID
Mild opioid eg codeine
Strong opioid eg morphine

+-Adjuvant

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18
Q

Give 2 examples of adjuvant pain killers?

A

Gabapentin

Tricyclics eg amitriptyline

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19
Q

Give examples of a mild and strong opioid

A

Mild codeine

Strong morphine

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20
Q

What are the main SEs of morphine?

A

Withdrawal
Resp depression
Emesis

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21
Q

What drug can be given for morphine induced nausea?

When is it contraindicated?

A

Metoclopramide

CI Parkinson’s since DA antagonist

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22
Q

What drug can reverse morphine?

A

Naloxone

23
Q

What is the PO version or morphine called?

A

Oromorph

24
Q

What version of morphine is prescribed for background pain?

A

PO MST

25
Q

What version of morphine is prescribed for breakthrough pain?

A

PO oromorph PRN

26
Q

How does opioid toxicity present?

A

Hallucinate, vivid dreams, twitch myoclonus, drowsy

27
Q

What drugs should be stopped in a palliative PTx who is currently dying?

A

Statins and anticoagulants

28
Q

What anticipatory drug is given for nausea in a palliative PTx?

A

Levomepromazine 2.5mg IJ

29
Q

What anticipatory drug is given for distress in a palliative PTx?

A

Midazolam 2mg SUB

30
Q

What anticipatory drug is given for secretions in a palliative PTx?

A

Buscopan aka hyoscine butylbromide IJ 20mg

31
Q

What is the name for vit D supplements?

A

Accrete

32
Q

Why are PO NSAIDs not given long term in the elderly?

A

Kidney function and gastric ulceration

33
Q

“Food tasting funny” could be due to

A

Thrush or Fe anaemia

34
Q

Prochlorperazine & metoclopramide risk exacerbating which chronic condition?

A

Parkinson’s

35
Q

What are the two 1st line drug options for diarrhoea of unknown cause

A

Loperamide or codeine phosphate

36
Q

What drug should be given for chronic symptomatic diverticular disease w/ constipation

A

Fibre supplement

37
Q

BB should not be given to PTx with what common chronic condition that has a strong association with smoking and chest infections?

A

Stop BB if COPD

38
Q

What antihypertensive shouldn’t be given to patients with chronic constipation?

A

CCB

39
Q

What antihypertensive is 1st line in CHF?

A

ACEI

40
Q

What antihypertensive is 1st line post MI?

A

ACEI

41
Q

If PTx with benign prostatic hyperplasia and HTN is prescribed an alpha blocker and antihypertensive, what side effect are they at high risk of?

A

Postural hypotension

42
Q

When are statins a futile prescription?

A

Short life expectancy

43
Q

Post VTE, what drug should be used long term?

A

Warfarin

44
Q

What is the anticoagulant of choice in AF?

A

Warfarin long term

45
Q

In adult a standard fluid bolus is 500ml, what is a standard fluid bolus in the elderly?

A

250ml

46
Q

What does MST stand for?

A

Morphine slow release tablet

the commonest strong opioid

47
Q

What is the only opioid safe in CKD?

A

Fentanyl

48
Q

Is morphine eliminated by the kidneys or liver?

A

Kidneys

49
Q

When verifying death, you must check if someone _____ since it will explode if they’re cremated

A

If they have a pacemaker

50
Q

A bolus dose of morphine one _____ of the daily morphine dose

A

1 sixth

51
Q

How does opioid toxicity present?

A

Hallucinations, myoclonus, resp depression, drowsiness

52
Q

In opioid toxicity, naloxone should be given if _____

A

RR less than 8

53
Q

What is the indication of loperamide?

A

Diarrhea

54
Q

Are acidic or basic drugs more easily absorbed in the elderly?

A

Basic

Y3 Ageing (4 decks)

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