Flashcards in Medicine for the elderly Deck (12)
What are the current demographics?
18% population pensionable
Fastest growing segment >80 yrs
Why is there an economic burden?
Increased cost of social care and home care
What are the 4 types of personality?
INTEGRATED - active, satisfied, flexible, functioning
ARMOURED - fights ageing, preoccupied with loss
PASSIVE - dependent, low level of life satisfaction
ANGRY - low activity, low life satisfaction, bitter
What physiological changes occur with ageing?
SKIN - wrinklied, dry, cambell de morgan spots, keratosis
MOUTH - less saliva production, impaired muscles of mastication, tooth loss, less taste buds, poorer sense of smell, tongue enlargement
IQ - verbal scores preserved but speed of response decresed
OTHER - reduced hepatic drug metabolism, reduced GFR, prostate enlargement, decreased bladder capacity, bone loss, valve thickening, lens hardens, less lean body mass, increased fat mass, inability to maintain body temp, lower oestrogen levels, increased immune deficiency
How can a disease present?
Specifically or non specifically
What is specific disease presentation?
Atypical presentation - MI without chest pain
Multiple pathology - immobility leading to DVT
Symptoms attributed to age - hypothyroidism, anaemia
Single illness leads to catastrophic outcome- pneumonia, fractures
What is non specific disease presentation?
Intellectual failure, incontinence, immobility, instability
What is the link with elderly and pharmacology?
More likely to be on multiple medications, multiple disease, primary and secondary prevention
How does age alter pharmacology?
Renal drug clearance is reduced, changes to hepatic drug metabolism
How does age affect the volume of distribution of drugs?
Ratio of fat : lean muscle increases so:
Lipid soluble drugs have more volume of distribution leading to more prolonged effect eg diazepam
Water soluble drugs have reduced volume of distribution leading to more rapid peak eg digoxin
What % drug - drug interaction result in an adverse effect?