Flashcards in Polypharm overview Deck (26):
decreases in asbsorption with age
decreased small bowel surface area
slowed gastric empything
increased gastric pH
rates of drug metabolism have what type variability
person to person
drugs with what conjugation don't have an affected clearance
what kidney test should be used to evaluate kidney function
if a patient is taing a benzo what should you make sure they aren't taking?
what may valerin affect?
Decrease in distribution reasons
Decrease in lean body mass (muscle) & increase in total body fat
Decrease in total body water
Decrease in serum albumin
Changes in metabolism with age
Liver mass & hepatic blood flow decrease
Decreased first pass metabolism
Rates of drug metabolism have person-to-person variability
Multistage metabolic clearance likely more prolonged
Drugs w/glucuronic acid conjugation - clearance not affected
Changes in elimination with age
Age related decrease creatinine clearance varies person-to-person
Dynamics renal vs. systemic clearance & drug’s maximum tolerated dose vs. minimum effective dose
What are 3 drugs that old people are on in nursing home?
What are 3 drugs that old people are on in community dwelling?
May - intensify/prolong sedatives; reduce iron absorption, increase bleeding risk/warfarin d/t phytocoumarins
May – potentiate drugs /cytochrome P-450 (amiodarone, methotrexate)/monitor LFTs
May – additive vaso-constrictive effects; inhibit platelet aggregation/additive effect, reduce iron absorption, additive effect/warfarin
May – inhibit platelet aggregation & fibrinolytic effect, augment Warfarin’s effect, augment anti-HTN meds
May - inhibit platelet aggregation, augment Warfarin’s effect
May – decrease efficacy anticonvulsants d/t contaminants, augment inhibition platelet aggregation/NSAIDS, augment Warfarin’s effect
May – intensify anti-DM agents (glipizide), augment ASA/platelet aggregation inhibition, intensify steroid effects d/t anti-inflammatory properties, increase digoxin levels, reduce effectiveness opioids, augment Warfarin effects
Augment effects sedatives (benzodiazepines)
May – reduce effect/digoxin, reduce iron absorption, increase photosensitivity, augment SSRIs, TCAs, reduce Warfarin level
St. John's Wort
Augment effects sedatives
______ is least affected by age
What are 3 non age related effects on excretion that should also be considered in elderly?
intrinsic renal disease
Age-related changes in tissue sensitivity that affect responsiveness to drug concentrations
What is the confusion assessment method?
Used to screen for delirium
Administered in <5 minutes
Does not assess severity or cause