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Flashcards in Elderly Pharm-PPt Josh Deck (47)
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1

Thankyou teresa and remember......

 

round eyes on the right

 

2

Physiology:

Physiologic changes that occur during aging can effec pharmcological responses including what 3 main things

  • Plasma protein binding
  • Body content
  • Drug metabolism

3

Physiology:

what happens to the plasma protein albumin (acidic)

 

decreased

4

Physiology:

what happens to the plasma protein Alpha1-acid glycoprotein (base)

Increased

5

Physiology: Body content

what happens to lean body mass

 

Decreased

6

Physiology: Body content

what happens to body fat

Increased

7

Physiology: Body content

what happens to total body water

Decreased

8

Physiology: Body content

recap what are the 3 maoin body content changes that affect how drugs work

  • decreased muscle mass
  • increased Body fat
  • decreased total body water

9

Physiology:Water soluble drugs

what happens to Vd

 

Smaller

10

Physiology:Water soluble drugs

wha happes to plasma concentration of drugs

Higher

11

Physiology:Water soluble drugs

what will happen to pharmacological effect

Increase

12

Physiology: Lipid soluble drugs

what happens to Vd

 

Larger

13

Physiology: Lipid soluble drugs

what happens to plasma concentration

Lower

14

Physiology: Lipid soluble drugs

what happens to elimination

Prolonged

15

Physiology: Drug Elimination

in the liver the liver volumes decreases 20-40%, hepatic blood flow decreases 10% per decade, and there is a decrease innate capacity to metabolize drugs. this all leads to what r/t drug metabolisim

it decreases

16

Physiology: Drug Elimination

the renal changes are decreased plasma flow, GFR  decreases 6-8% per decade, and renal fxn in reduced, this all leads to what r/t excretion ability of drugs

it decreases

17

Physiology: Summary

name the effects

  1. Decreased vascular volume
  2. decreased protein binding
  3. increased total body lipid stores
  4. Decreased renal and hepatic blood flow

  1. high inital plasma concentration
  2. Increased availability of free drug
  3. Prolomnged action of lipid soluble drugs
  4. Prolomged action of drugs dependent on kidney and liver elimination

18

Pharmacology: Benzodiazepines

what happens to Vd

Increased

19

Pharmacology: Benzodiazepines

what happens to elimination 1/2 life

prolonged

20

Pharmacology: Benzodiazepines

Versed- the reuirements are about ___% less

50%

21

Pharmacology: Benzodiazepines

Versed- elimination 1/2 life is prolonged from 2.5 to__ hours

4

22

Pharmacology: induction drugs

There is a delayed induction time and onset of IV drugs d/t what 3 things

  • impaired Myocardial pump
  • Reduced CO
  • Decreased Perfusion of organs

23

Pharmacology: induction drugs: Propofol

requires nearly ___% lower blood levels than a younger pt

 

50%

24

Pharmacology: induction drugs: Propofol

there is a dramatic decrease in what

Systemic BP

25

Pharmacology: induction drugs: Propofol

is the a longer or quicker recovery of cognitive fxn

Quicker

26

Pharmacology: Inhaled Anesthetics

there is a _____ requirement

Reduced

27

Pharmacology: Inhaled Anesthetics

MAC is reduced __-__% perdecade of life after age 40

4-6%

28

Pharmacology: Inhaled Anesthetics

what happens to inhalation agent uptake if there is a decreased CO

More rapid

29

Pharmacology: Inhaled Anesthetics

the ______ depressamt effects of VAAs are exaggerated

Myocardial

30

Pharmacology: Inhaled Anesthetics

there is a prolonged recovery from anesthesia w/ VAAs b/c of what 3 things

  • Increased Vd
  • Decreased Hepatic fxn
  • Decreased Pulmonary gas exchange