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adult gero > exam 3 > Flashcards

exam 3 Flashcards

(50 cards)

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1
Q

ANY NEW SYMPTOM IN AN OLDER ADULT IS A MEDICATION SIDE EFFECT UNTIL PROVEN OTHERWISE

A

Constant Differential

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2
Q

Pharmacokinetics

A

absorption
distribution
metabolism
excretion

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3
Q

Impacts speed at which a drug can become available

Least affected by aging

A

absorption

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4
Q

Movement of drug thru the circulatory system to the target area

Affected by age

A

distribution

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5
Q

3 changes in older adults that effect distribution

A

Decrease of body water
Decreased plasma protein
Changes in fat distribution

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6
Q

Biotransformation

Metabolite/Isoenzymes-pharmacogenetics
Enzyme changes

A

Metabolism

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7
Q

what are the 3 key elements of STEADI

A

Screen, Assess, and Intervene

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8
Q

decreased physiologic reserve in multiple systems that are interdependent

Accumulation of losses
Inability to compensate for other systems
Difficulty maintaining homeostasis

A

frailty

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9
Q

Is frailty a progressive process of aging?

A

Primary Frailty

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10
Q

Is frailty the result of an accumulation of geriatric syndromes, aging changes and chronic health problems ?

A

Secondary frailty

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11
Q

Frailty theory defined clinical symptoms

A

Fried

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12
Q

Frailty theory research –accumulation of deficits

A

Rockwood

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13
Q

5 identifiers with cycle of frailty

A 
chronic under nutrition 
sarcopenia 
decreased strength and power 
walking speed 
decreased activity
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14
Q

Age related loss of lean body mass

A

Sarcopenia

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15
Q

freid definition of frailty is the presence of 3 or more of the following 5 things:

A 
Unintended weight loss
Exhaustion
Slow walking speed 
Low physical activity
Weakness
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16
Q

Screening for frailty

Assessment

A

AGS Frailty tool

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17
Q

Chief complaint-absent
S&S do not point to one organ system or one disease
Any stressor can become a risk for health outcomes
Impact on function

A

assessment issues with frailty

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18
Q

5 domains of cognition

A 
memory 
executive functioning (ability to make decisions)
attention
language 
visual spatial perception
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19
Q

Does NOT interfere with independence
IADL’s are intact
NOT delirium or other mental disorder

A

mild cognitive impairment

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20
Q

Disrupted Alpha-synuclein protein inside the cell destroying the neuron

Motor deficits
visual hallucinations/delusions
Parkinsonism
Fluctuating changes in alertness & attention

A

Lewy Body Dementia

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21
Q

Blocked or reduced blood flow to brain

often occurs after a stroke

will not change or get worse unless another stroke occurs

Study These Flashcards
A

Vascular Dementia

22
Q

Average age of onset is 50-60

Group of disorders caused by progressive nerve cell loss in frontal lobes or temporal lobes

Behavior type-change in personality/behavior, angry, hyperorality, impulse control issues, executive function

Study These Flashcards
A

Frontotemporal Lobe Dementia

23
Q

Accumulation of extracellular protein plaques

Prevents communication between neurons

Study These Flashcards
A

Alzheimer’s disease

24
Q

7 Sensory Changes with Alzheimer’s

Study These Flashcards
A 
Decreased contrast sensitivity
Tunnel vision
Motion blindness
Depth perception
Touch (hot and cold)

Auditory processing
(Sensitivity to sounds)
(Speech issues)
(Loud noises)

25
AD where: genetic mutations-apolipoprotein E4 (APOE4) gene Are heart and brain health related? Women?
Late onset
26
AD where associated with mutated gene APP (amyloid precursor proteins) Rare accounts for approx. 3% of all AD cases
Early onset familial AD (FAD) before age 60
27
8 questions to ask the family members for AD
AD8
28
6 diagnostic labs to rule out dementia
CBC, TSH, u/a, LFT, Vit B12, ECG,
29
stage in AD where Measurable changes of biomarkers in brain, cerebrospinal fluid and blood (Only used for research purposes) NO noticeable symptoms of AD
preclinical
30
Mild impairment in memory or one cognitive domain without impact on function
mild cognitive impairment
31
% of patients with MCI convert to AD annually
12%
32
stage of AD where Occasional forgetfulness, misplacing objects, difficulty planning, speech i.e. trouble finding the right word
mild
33
stage of AD where Forgetting own history, inappropriate clothing, wandering, behavioral and psychological symptoms (BPSD)
moderate
34
stage of AD where Continuous assistance with ADL’s, physical decline i.e. immobility, dysphasia, inability to communicate meaning fully, increased susceptibility to infection
severe
35
Slow break down of neurotransmitter acetylcholine (Acetylcholine is related to memory) Modest delay in cognitive decline in early to moderate dementia (AD & Lewy body hallucinations)
Cholinesterase inhibitors
36
Reduces glutamate- mediated excitability Modest beneficial effects on cognition, ADL’s and behavior in moderate to advanced dementia
Memantine
37
6 Behavioral & Psychological Symptoms of Dementia
``` aggression mania agitation psychosis depression apathy ```
38
What the drug does to the body
PHARMACODYNAMICS
39
why should you start low with medications in older adults
Changes in volume of distribution, protein binding and pharmacodynamics
40
why should you go slow with medications in older adults
Changes in metabolism and excretion
41
Polypharmacy > __ meds
5
42
4 common side effects of Anticholinergics
Sedation Confusion Urinary retention Constipation
43
unfavorable & unexpected medical event r/t drug May need to be reported to FDA Unpredictable
adverse drug event
44
can cause harm even if drug dosage was within normal limits Known adverse drug reaction
adverse drug reaction
45
2 most common underused drugs
Anticoagulants in afib Anti-platelet therapy in arterial disease
46
5 beers criteria tables
1. potentially inappropriate meds in general 2. drugs to avoid in older adults with certain diseases 3. medications to use with caution 4. meds to be avoided based on kidney function 5. list of common drug drug interaction
47
Addresses PIMs associated with ADR’s
STOPP criteria (Screening Tool of Older Persons' Prescriptions)
48
Addresses prescribing omissions
START (Screening Tool to Alert to Right Treatment)
49
4 steps in deprescribing
Assess all meds and indication for use Consider risk/benefit of medication Prioritize meds to discontinuation Implement and monitor discontinuation plan
50
2 screening tools for depression
PHQ-2 (patient health questionnaire) Geriatric Depression Scale

adult gero (3 decks)

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