Lifespan Considerations

Question 1

Category A drug

Answer 1

no risk to fetus

Question 2

B drug

Answer 2

no risk to animal fetus; info for humans not available

Question 3

D drug

Answer 3

possible fetal risk (potential benefit vs. risk)

Question 4

X drug

Answer 4

fetal abnormalities reported & positive evidence of fetal risk in humans. Do not use for pregnant women

Question 5

Considerations for older adults

Answer 5

1. decline in organ function
2. drug therapy results in adverse effects/toxicity
3. High use of meds
4. Noncompliance, non-adherence

Question 6

Polypharmacy

Answer 6

use of 4 or more medications throughout day

Question 7

Absorption 
Gastric pH is
Gastric emptying is...bc
BF is
absorptive surface is

Answer 7

less acidic
slowed bc decreased muscle tone & activity
reduced
reduced

Question 8

Distribution what happens? (3 things)

Answer 8

1. Lower total body water percentages
2. Increased fat content
3. Decreased production of proteins by the liver, decreased protein binding

Question 9

Metabolism what happens?

Answer 9

1. produces fewer microsomal enzymes

2. Reduced blood flow to liver

Question 10

Excretion

Answer 10

1. Decreased glomerular filtration rate
2. Decreased number of nephrons (in kidneys)
   DRUGS ARE LESS EFFECTIVE BC OF DECREASED EXCRETION

Question 11

Confusion, constipation, urinary retention, vomiting, respiratory depression, falls

Answer 11

OPIODS

Question 12

Edema, nausea, gastric ulceration, bleeding, renal toxicity

Answer 12

NSAIDs

Question 13

Major & minor bleeding episodes, many drug interactions, dietary interactions

Answer 13

Anticoagulants (heparin, warfarin)

Question 14

Blurred vision, dry mouth, constipation, confusion, urinary retention, tachycardia

Answer 14

Anticholinergics

Question 15

Nausea, hypotension, diarrhea, bradycardia, ♡ failure, impotence

Answer 15

Antihypertensives

Question 16

visual disorders, nausea, diarrhea dysrhythmias, hallucinations, decreased appetite, weight loss

Answer 16

Cardiac glycosides (digoxin)

Question 17

Sedation, weakness, dry mouth, confusion, urinary retention, ataxia

Answer 17

CNS depressants (muscle relaxants, opioids)

Question 18

confusion, daytime sedation ataxia, lethargy, increased risk for falls

Answer 18

Sedatives & hypotonics

Question 19

Electrolyte imbalance, rashes, fatigue, leg cramps, dehydration

Answer 19

Thiazide diuretics

Question 20

Evaluation (3 things)

Answer 20

a. Observe and monitor for therapeutic effects
b. Observe and monitor for adverse effects
c. Evaluate understanding of drug purpose, dose, dose frequency, adverse effects, special considerations

Question 21

Physiologic Changes in the Older Adult Patient: Cardiovascular

Answer 21

1. Decreased CO= decreased absorption & distribution

2. Decreased BF= decreased absorption & distribution

Question 22

Physiologic Changes in the Older Adult Patient: Gastrointestinal

Answer 22

1. Increased pH (alkaline gastric secretions) =altered absorption
2. Decreased peristalsis=delayed gastric emptying

Question 23

Physiologic Changes in the Older Adult Patient: Hepatic

Answer 23

1. Decreased enzyme production= decreased metabolism

2. Decreased BF= decreased metabolism

Question 24

Physiologic Changes in the Older Adult Patient: Renal

Answer 24

1. Decreased BF= decreased excretion
2. Decreased function= decreased exertion
3. Decreased Glomerular filtration rate= decreased excretion

Question 25

``` Drugs requiring special caution/monitoring for this condition: Anticholingerics antihistamines decongestants antidepressants ```

Answer 25

Bladder flow obstruction

Question 26

Drugs requiring special caution/monitoring for this condition: NSAIDs Aspirin anti-platelet drugs

Answer 26

Clotting disorders

Question 27

Drugs requiring special caution/monitoring for this condition: calcium channel blockers tricyclic antidepressants anticholingerics

Answer 27

Chronic constipation

Question 28

Drugs requiring special caution/monitoring for this condition: Long acting sedatives or hypnotics narcotics beta blockers

Answer 28

COPD

Question 29

``` Drugs requiring special caution/monitoring for this condition: Sodium decongestants amphetamines OTC cold products ```

Answer 29

♡ failure, hypertension

Question 30

Drugs requiring special caution/monitoring for this condition: Decongestants bronchodilators monoamine oxidase inhibitors

Answer 30

Insomnia

Question 31

Drugs requiring special caution/monitoring for this condition: Antipsychotics Phenothiazines

Answer 31

Parkinson's disease

Question 32

``` Drugs requiring special caution/monitoring for this condition: Sedatives hypnotics opioids CNS depressants muscle relaxants antidepressants antihypertensives ```

Answer 32

Syncope, falls