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Gerontological RN exam > Medications > Flashcards

Flashcards in Medications Deck (26)
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0
Q

The higher incidence of drug reactions in older adults is caused by?

A

Impaired drug metabolism due to decreases in Glomeruler filtration rate and hepatic clearance changes in volume distribution of drugs and individual variation in sensitivity to drugs

1
Q

Adverse drug reactions are 2 to 3 times greater in older adults and account for what percentage of their hospital admissions?

A

10-35 Percent.

2
Q

A list used as a guide to assist healthcare providers improve medication safety for Older adults and inform clinical decisions making concerning the quality of care.

A

AGS BEERS

3
Q

Refers to what a body does to the drug. It is the impact of absorption, distribution, metabolism, and in elimination of drugs.

A

Pharmacokinetics

4
Q

Drug distribution is affected by three things. Name them.

A
  1. Body water
  2. Body fat
  3. Lean body mass
5
Q

As human beings age they have less Body water and intracellular water. What can these changes lead to?

A

Increased concentrations of water soluble drugs.

6
Q

As people age their added body fat may do what to their drug distribution?

A

Added body fat may increase the distribution of fat soluble drugs such as benzodiazepines causing prolonged half-lives and accumulation of the drug in the fat stores of the body.

7
Q

Decreased lean body mass can cause what in drug distribution?

A

Causes an increase in Serum concentration of protein bound drugs such as warfarin or Lanoxin. Nurses should pay particular attention to protein found drug use in malnourished older patients.

8
Q

The amount of the drug that reaches systemic circulation is known as?

A

Bioavailability. This also affects drug distribution and may be altered by the route of administration, drug solubility, and general circulation to the site where the drug is given.

9
Q

Changing drugs to more active forms occur in all tissues of the body but the main site is in the liver. Through this the liver detoxifies drugs and prepares them for excretion.

A

Biotransformation

10
Q

The process of biotransformation takes place through complex enzyme activity that occurs in the?

A

Cytochrome p450 system.

11
Q

Concomitant Diseases, gender, genetics, nutrition, activity levels, and caffeine, tobacco and alcohol ingestion all affect what?

A

Metabolism of drugs

12
Q

The liver metabolizes drugs in one of two ways. Name the two ways.

A

Phase 1) Oxidation or reduction.

Phase 2) Conjugation

13
Q

Refers to when a drug is metabolized by the liver into more polar compounds.

A

Phase 1) Oxidation or reduction.

14
Q

Liver metabolism of a drug to a more water soluble molecule.

A

Phase 2) conjugation.

15
Q

Refers to the specific action of a drug at the tissue level.

A

Pharmacodynamics

16
Q

The most significant change with relation to drug use and effects in older adults is the age related changes to what?

A

Kidneys

17
Q

Beginning between the ages of? & ?, The glomerular filtration rate begins to fall approximately 1% per year based on age alone.

A

35-40 years.

18
Q

Older adults who have the following conditions are as specially at risk when given medications that are excreted renally such as digoxin, and vancomycin and imipenem.

A

Hypertension
Diabetes
Chronic medical conditions

19
Q

Is an indirect measure of glomular filtration rate.

A

Creatinine clearance

20
Q

True or false, an older adult that has a normal serum creatinine will have a normal creatinine clearance.

A

False

21
Q

Polypharmacy can be defined as?

A

Taking more than six medications on a daily basis. Taking multiple medications that interact with one another. Taking medications to counteract the side effects of other medications.

22
Q

Adverse drug reactions cause what percentage of all hospitalizations in older adults?

A

28%

23
Q

In patients who are on multiple medications that develop a new symptom, the nurse should consider what?

A

That it could be an adverse drug reaction.

24
Q

What is the guiding principle for prescribing medication for the older person?

A

Start low and go slow.

25
Q

This herbal remedy can cause photosensitivity and possible serotonin syndrome if used with an SSRI.

A

St. John’s wort.