Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology 2 > Pharm in Elderly > Flashcards

Pharm in Elderly Flashcards

(63 cards)

Start Studying
1
Q

what physiological change leads to the greatest effect on pharmacokinetics and pharmacodynamics?

A

decreased hepatic and renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

why is absorption of certain drugs changed in elderly patients? (2)

A

longer gastric emptying time
decreased gastric acid production = alkaline environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what 4 drugs will have less bioavailability and exposure in elderly patients due to their decreased gastric acid production?

A

ketoconazole
itraconazole
atazanavir
kinase inhibitors (COVID)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how does a decreased body water in elderly effect distribution? what’s a drug example?

A

increase concentration (Cp) of hydrophilic drugs (lithium)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does a decreased lean body mass in elderly effect distribution? what’s a drug example?

A

decreased volume of destribution (Vd) for drugs that bind to muscle (digoxin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does increased fat in elderly effect distribution? what’s a drug example?

A

increase half life of lipophilic drugs (diazepam)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how does a decreased albumin in elderly effect distribution? what’s a drug example?

A

increase concentration of unbound drugs (warfarin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does a decreased alpha-acid glycoprotein in elderly effect distribution? what’s a drug example?

A

increased concentration of unbound drugs (propranolol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what must be done in elderly when there is an increased effect on distribution?

A

decrease dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

obesity in elderly leads to higher bioavailability of ____________ drugs

A

lipid-soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ascites in elderly leads to higher bioavailability of ____________ drugs

A

water-soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does a decrease in perfusion and cardiac output lead to in elderly? (5)

A

increased drug circulation time
prolonged distribution
delayed absorption
delayed Tmax
delayed onset of effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how is distribution effected in elderly? (2)

A

decreased efficacy of BBB = increased pharmacological response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how is metabolism in the elderly effected? (3)

A

decreased liver size
lower liver blood flow
reduced phase 1 activity (P450 enzyme)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which 3 drugs that go through phase 1 activity (P450 enzyme) will have lower metabolism in elderly?

A

diazepam to desmethyldiazepam
temazepam
oxazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which type of drugs do we want to use in elderly to maintain normal metabolism?

A

phase 2 inactivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what 3 drugs that go through phase 2 inactivity will help maintain a normal metabolism in elderly?

A

lorazepam
temazepam
oxazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how will bioavailability be affected in elderly after oral administration?

A

increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is excretion of drugs effected in elderly? what 2 drugs?

A

decreased
penicillin
aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what causes a change in excretion of drugs in elderly? (4)

A

decreased renal blood flow
decreased GFR
decreased functioning neurons
decreased tubular secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

during which 2 times are compensatory mechanisms important to maintain glomerular perfusion pressure and renal function?

A

periods of decreased intravascular volume
periods of decreased perfusion pressure d/t renal artery stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

which 2 endogenous substances compensate to maintain glomerular perfusion pressure and renal function? what are their jobs?

A

angiotensin II - potent vasoconstrictor (efferent)
PGs - potent vasodilator (afferent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

which 3 drugs are problematic to GFR in elderly patients?

A

ACEI
ARBs
NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how do NSAIDS affect GFR?

A

block PGs
cause vasoconstriction
less fluids into glomerulus
lower pressure
lower GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how do ACEIs and ARBS affect GFR?
increase vasodilation drops pressure drops kidney function risks renal failure
26
how is the baroreceptor reflex different in elderly? (3)
decreased ability to buffer BP changes cannot compensate for volume shift decreased CNS perfusion
27
drug class that relaxes smooth muscle at the bladder neck and prostate, and helps bladder emptying and increases urine flow; used for benign prostatic hyperplasia
alpha-1 adrenoceptor antagonist
28
why are alpha-1 adrenoceptor antagonists not recommended for elderly? (2)
decrease calcium influx into smooth muscle cells drops blood pressure
29
elderly are more susceptible to the orthostatic effects of which 4 medications?
vasodilators diuretics alpha blockers (-sin) tricyclic antidepressants
30
what does a decrease in the number or affinity of beta receptors lead to?
beta agonists + beta blockers become less effective
31
what does a decrease in cholinergic receptors and level of acetylcholine lead to?
decreases cognition and memory
32
elderly patients are more sensitive to antagonists of cholinergic receptors. what does this lead to? what are 5 drugs?
exacerbations of cognitive impairments and delirium TCAs anti-emetics urinary antispasmodics muscle relaxants antihistamines
33
elderly have an increased sensitivity to dopamine antagonists. what are 2 drugs?
antipsychotics metoclopramide
34
what do dopamine antagonists (antipsychotics and metoclopramide) lead to?
increased extra-pyramidal effects
35
what can be a problem in elderly with dopaminergic synthesizing capacity close to the threshold point?
decreased dopamine synthesis in substantia nigra
36
what could all dopamine blockers produce in elderly?
drug-induced parkinsonism
37
an elderly patient is presenting with uncontrolled movements, grimacing, tongue movements, eyes rolling back, and twisting neck. what is this patient likely taking?
dopamine blocker
38
an elderly patient presents with amnesia, agitation, delirium, sedation, psychomotor impairments, ataxia, and imbalance. what are they likely taking?
benzodiazepines
39
an elderly patient presents with drowsiness, sedation, constipation, and respiratory depression. what are they likely taking?
CNS depressants antihistamines antipsychotics antidepressants opioids
40
what do antacids cause in elderly? (2)
acid-base imbalance constipation
41
what do corticosteroids cause in elderly? (2)
sodium retention osteoporosis
42
in which patients is osteoporosis worse d/t long-term corticosteroid use?
elderly women with low estrogen
43
what do hypoglycemics and insulin cause in elderly? what can make it worse? (3)
hypoglycemia missed meals alcohol intake increased exercise
44
what do anti-asthmatics cause in elderly? (2)
palpitations tachycardia
45
what do opiates cause in elderly? (2)
analgesia respiratory depression
46
what do NSAIDS cause in elderly? (3)
GI bleed renal impairment heart failure
47
what do ACEIs and ARBs cause in elderly? (2)
increased serum creatinine increased potassium
48
why should we be cautious with digoxin in elderly?
lower distribution to muscles d/t less muscle increased concentration in plasma
49
what are the 2 most common ADR and what drugs cause them?
increased falls/fractures (antihypertensives) urinary retention (anticholinergics)
50
elderly tend to have therapeutic duplication with medication that look alike; which 2 meds can cause visual impairments?
antifungals anticholinergics
51
what meds can cause motor problems in elderly?
diuretics
52
what 2 drugs inhibit the renal tubular secretion of procainamide?
cimetidine trimethoprim
53
what drug inhibits the renal tubular secretion of penicillin?
probenecid
54
what drug inhibits the renal tubular secretion of flucloxacillin?
piperacillin
55
who is the AGS Beers criteria for?
all ambulatory, acute, and institutionalized setting, except hospice and palliative care
56
what can calcium channel blockers and iron cause?
constipation
57
what can alpha-blockers cause?
orthostatic hypotension
58
what can anti-histamines and TCAs cause? (5)
blurred vision dry mouth tachycardia constipation urinary retention
59
what can benzodiazepines cause?
ataxia/falls
60
what D-D interactions exist with warfarin? (5)
NSAIDs sulfa drugs macrolides quinolones phenytoin
61
what D-D interactions exist with ACEI? (2)
K supplements spirolactones
62
what D-D interactions exist with digoxin? (2)
amiodarone verapamil
63
what D-D interaction exists with theophylline??
quinolones

Pharmacology 2 (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions