geri Flashcards
(37 cards)
Cure for Brain Aging might entail
(1) Termination of degeneration (2) Creation of new Neurons (3) Enable correct re-wiring
Immediate research goals for geriatric psychpharm
(1) Retard rate of decline (2) Prevent or retard onset
Potential issues with Geriatric PsychPharm
(1) Polypharmacy (2) Adverse Drug Reactions (3) Inappropriate Meds (4) No treatment (5) Non-compliance (6) Impaired drug metabolism
% of older adults in population and % of prescriptions given to older adults
13% in population–recieve 30% of all prescriptions
General principle in prescribing drugs
Start low and go slow
Reason for start low and go slow
Often the elemination half-lives are longer in older people which means they stay in the body longer. Repeated dosages can lead to a high steady state…. Especially with sedative-hypnotics, these effects can dribble over into the following day causing continued impairment
Common problem for diagnosis in depression and anxiety
Underdiagnoses
Main drugs to avoid for older patients
(1) Ones that cause cognitive inhibition (2) Unwated sedation (3) Bizarre Behaviors
BPSD
Behavioral and Psychological Symptoms of Dementia
Typical treatment for BPSD
Atypical antipsychs [Abilify best]
BPSD Symptoms
Agitation, aggression, noncompliance with care, psychosis, depressive symptoms, inappropriate sexual behavior, sleep disturbances
Problem with prescription of antipsychs in geriatic
Many eldery patients are placed in anti-psychs without any clear reasoning (no diagnoses psychosis or dementia)
Depression and Older
65+ account for 20% of all suicides with a high completion rate. Best treatment: antidepressants/psychotherapy
Non-prescription approaches to some aging related problems
(1) Exercise (2) Healthy diet (3) Deep breathing (4) Omega 3 FA (5) Cogntitive behavioral therapy (6) Vitamins D,E, Q10 (7) Yoga laughter
Why side effects result
(1) Polymorbidity can lead to polypharmacy which can cause side effect (2) Decreased organ function can cause changes in pharmacodynamics and decrease homeostatic functions… which can cause side effects
Trend between number of drugs and ADR’s
More drugs= more ADR
Trend between # of prescribing physicians and ADRs
More physcians= more ADR
Prevalance of Parkinson’s Disease
1% of people 65-69
Cause of Parkinson’s Disease
Symptoms result from a deficency in the # and functioning of DA-secreting neurons in the substantia nigra
What are two DA pathways in vertebrate brain?
Substantial Nigra for motor and DA from VTA from fortal lobes and limbic systems
Three approaches to treating PD
(1) Replace DA using precursors (2) Deminish breakdown of DA (3) DA receptor agonist
Clinical symptoms of 80% DA loss
Bradykinesia, muscle rigidity, resting tremor, impaired postural balance
Potential enviornmental cause of PD
Tri-chloro ethylene
Process for how Dopa becomes Dopamine
Dopa can be impacted by the enzyme dopa decarboxylase into becoming Dopamine