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Clin Med II Exam 4 > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

what medication for pain should not be used in pts taking warfarin?

A

NSAIDs

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2
Q

What should be taken into consideration when prescribing drugs to elderly pts?

A

liver or renal dysfunction, have less water and more fat so fat soluble drugs linger and water soluble drugs are more concentrated

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3
Q

common drugs implicated in polypharmacy for geriatrics

A

warfarin, opiates, antiplatelets, hypoglycemic drugs, digoxin

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4
Q

anticholinergic effects

A

blind as a bat, red as a beet, dry as a bone, mad as a hatter, hot as a hare, can’t see, can’t pee, can’t shit, indigestion, dizziness, depression, derm effects

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5
Q

considerations for NSAIDs

A

make sure they have proper kidney function. ADR: GI upset, bleeding

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6
Q

considerations before ACEi

A

renal excretion, hyperkalemia common so check labs in 1 weeks. Same true for furosemide and HCTZ but hypokalemia

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7
Q

Drugs to avoid in elderly

A

Benzos, diphenhydramine, opiods, antipsychotics, warfarin, digoxin, insulin/sulfonylureas

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8
Q

MCC of neglect and abuse in elderly

A

self neglect

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9
Q

Definition of palliative care

A

improve quality of life via prevention and treatment

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10
Q

Benefits of hospice

A

increase pt satisfaction, reduce healthcare costs, decrease caregiver mortality

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11
Q

Time frame not determined, can be provided by anyone, do not have to be DNR, symptom care

A

Palliative care

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12
Q

Time frame <6 months, service from agency, need terminal diagnosis, must have DNR-cc order, symptom control

A

Hospice

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13
Q

Common terminal diagnoses

A

CHF, cancer, CVA, dementia, end stage renal disease, end stage liver disease, respiratory failure

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14
Q

why are pts not referred in an appropriate time frame?

A

clinician denial, pt denial, fear of dying

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15
Q

True or false: when delivering prognosis - be direct

A

true

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16
Q

stages of dying

A

denial and isolation, anger, bargaining, depression, acceptance

17
Q

DNAR

A

Do not attempt ressuscitation

18
Q

DNR-cc

A

withold CPR, MV, hydration (unless for comfort), cardiac monitoring. If responding to an emergency before checking protocol, stop all efforts except respiratory assistance, IV meds that have been used in the pts ongoing tx

19
Q

true or false: should refer to palliative care or pain management if unable to manage pain

A

true

20
Q

buprenorphine, fentanyl

A

transdermal opiates

21
Q

new hydrocodone, ER’s, levophanol, oxymorphone

A

long acting opiates

22
Q

how to treat nausea from opiates

A

haloperidol, phenergan, reglan, zofran

23
Q

burning, shooting, pins and needles, electricity, numbness

A

neuropathic pain

24
Q

treatment of neuropathic pain in elderly

A

TCA’s (desipramine, nortryptiline), gabapentin, pregabalin, SSNRIs (duloxetine, venlafaxine), drabinol, tramadol and lidocaine patch

25
Q

adjuvant tx for neuropathic pain

A

low dose meds in combom nerve blocks, cannabinoids, ketamine, corticosteroids, intrathecal pumps

26
Q

Nonpharmacologic treatment of pain

A

framing, biofeedback, obvious

27
Q

treatment of dyspnea

A

opiates, oxygen, CPAP/BiPAP, relaxation, benzo’s

28
Q

Nausea and vomiting from peripheral nerves from gut

A

small meals only when hungry

29
Q

N/V from constipation

A

metoclopramide, scopalamine patch

30
Q

N/V from vestibular disturbance

A

anticholinergic or antihistamine

31
Q

chemo induced N/V

A

benzos

32
Q

treatment of constipation

A

bisacodyl or senna, polyethylene glycol, stool softener, methylnaltrexone SC

33
Q

fatigue related to CA may be d/t

A

hypothyroid, hypogonadism, cognitive nd functional impairment, malnutrition

34
Q

treatment of fatigue in elderly

A

methylphenidate or modafinil, corticosteroids, exercise, address pain

35
Q

treatment of delirium and agitation in elderly

A

haldol, risperidone, midazolam, barbituates

36
Q

how to control airway secretions on life support

A

scopalamine, glycoyrrolate, stropine opthalmic solution

Clin Med II Exam 4 (5 decks)

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