elderly

Question 1

Does the amount of med absorbed inc or dec in the elderly?

Answer 1

STAYS THE SAME

Question 2

Describe how the peak concentration changes as you age? what is an exception to this?

Answer 2

lower and delayed

exception: drugs with first pass - bioavailability may inc

Question 3

Tell me 5 things that decrease as you age

Answer 3

1. liver mass / activity
2. GFR
3. total body water
4. muscle mass
5. gastric acidity

Question 4

What increases as you age?

Answer 4

fat content

Question 5

are phase I or phase II pathways preferred for breakdown of drugs in the elderly?

Answer 5

phase II

Question 6

Name some examples of phase II drugs

Answer 6

metoprolol

Question 7

Name some drugs that are protein bound

Answer 7

warfarin, barbituates, phenytoin, carbamezapine

Question 8

What drugs are their absorption affected by divalent cations

Answer 8

fluoroquinolones and tetracyclines

Question 9

Name some drugs that require dose reduction with dec GFR

Answer 9

aminoglycosides, fluoroquinolones, penicillins
procainamide, digoxin
metformin, lithium
bisphosphonates, clofibrates
thiazides, atenolol, fluconazole, ACEIs

Question 10

ozaepam is metabolized faster in men or women?

Answer 10

men

Question 11

nefazodone is metabolized faster in men or women

Answer 11

women

Question 12

smoking increases clearance of

Answer 12

theophylline

Question 13

Name some drugs that utilize hepatic metabolism

Answer 13

NSAIDs, aspirin, acetaminophen
calcium blockers, statins, beta blockers
tricyclics, SRIs
cimetidine, ranitidine, proton pump inhibitors
valproic acid , phenytoin
erythromycin
lidocaine

Question 14

What type of drug should you avoid since it blocks prostaglandins and dec renal clearance

Answer 14

NSAIDs

Question 15

Why is creatinine not a reliable measurement of GFR in the elderly? what should you use instead

Answer 15

production dec as you age

use cockroft and gault equation

Question 16

Which drugs have the highest potential for ADEs

Answer 16

anticholinergics - degenerate the brain

amitryptiline
chlorpromadide
pysopyramide
digoxin
GI antispasmodics
Merperidine
methyldopa
Ticlopidine

Question 17

What are some risk factors for ADEs

Answer 17

6 or more concurrent chronic conditions
12 or more doses/ day
9 or more meds
prior adverse drug reactions
LBW or BMI
age 85 or older
CrCl <50

Question 18

What can an ACE + diuretic cause

Answer 18

hypotension and hypokalemia

Question 19

what can ACE + potassium cause

Answer 19

hyperkalemia

Question 20

What can an antiarrythmic + diuretic cause

Answer 20

electrolyte imbalance and arrythmia

Question 21

What can a benzo + antidepressant cause

Answer 21

confusion and sedation, falls

Question 22

What can a ca blocker and diuretic cause

Answer 22

hypotension

Question 23

Whats the risk with megestrol, given in alzheimers patients to increase appetite

Answer 23

thrombotic events

Question 24

Why should insulin sliding scales and oral hypoglycemics be avoided?

Answer 24

risk of hypoglycemia

Question 25

What are the s/e of anticholinergics

Answer 25

dry as bone, blind as a bat, hot as a hare, red as a beet, mad as a hatter confusion, orthostatic hypotension, urinary hesitancy, dry eyes, pupil dilation, constipation

Question 26

Hepatic congestion from heart failure reduces absorption of what drug

Answer 26

warfarin

Question 27

What are the most common drug - drug interaction classes

Answer 27

cardiovascular and anti-psych

Question 28

Metclopramide should be avoided unless for gastoparesis, why?

Answer 28

risk of TD and EPS

Question 29

Why should NSAIDs be avoided?

Answer 29

GI bleeding

Question 30

Why should nitrofurantoin be avoided?

Answer 30

pulmonary toxicity

Question 31

Why should anti-psychs be avoided?

Answer 31

risk of CVA