Elderly Pharm-PPt Josh Flashcards Preview

Bioscience II Brandon > Elderly Pharm-PPt Josh > Flashcards

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

31

Pharmacology: Opioids

there is a decreased requirement for narcotics b/c of decreased what? (2)

 

  • Vd
  • Protein binding

32

 

Pharmacology: Opioids

there is a prolomnged elimination 1/2 time leading to what complicatins

decreased ventilation

prolonged analgesia

 

33

Pharmacology: Morphine

what is the metabolite or morphine

Morphine-6-glucuronide

34

Pharmacology: Morphine

does the metabolite morphine-6-glucuronide have analgesic properties?

Yes

35

Pharmacology: Morphine

the metabolite morphine-6-glucuronide depends on what type of excretion

Renal

36

Pharmacology: Sufenta, Alfentanil, Fentanyl

  1. are ____ as potent in elderly pt's

twice

37

Pharmacology: Remifentanyl

is ___ as potent

twice

38

Pharmacology: Remifentanyl

there should be a ___% reduction in bolus dose

50%

39

Pharmacology: Remifentanyl

there should be a ___-___% reduction in infusion rate

30-50%

40

Pharmacology: Muscle Relaxants

what happens to teh respons to both SCh and non-depol

nothing it's unchanged

41

Pharmacology: Muscle Relaxants

what happens to the onset time of NM blockade

prolonged

42

Pharmacology: Muscle Relaxants

there is a reduction in clearance and increased elimination 1/2 time. but wait there is one exception... what drug is it?

Cisatracurium

43

Pharmacology: Muscle Relaxants

elderly M or F display a prolonged effect from SCh

Men

44

Pharmacology: Cardiovascular

the is a ____ response to B-adrenergic agents

decreased

45

Pharmacology: Cardiovascular

the sysmpathetic response decreases why?

decreased number of sympathetic receptors

46

Pharmacology: Cardiovascular

you may have to _______ the dose for equal CV response

Increase

47

Thats it mother......

fucker