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32 Cards in this Set
- Front
- Back
What is the most important physiologic change of aging with respect to pharmacology?
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Decreased renal fxn
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TRUE or FALSE: organ system changes seen in aging are due to the aging process itself.
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FALSE-- they're d/t the changes of chronic disease (HTN, diabetes, etc)
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What is the Cockcroft-Gault equation for estimation of creatinine clearance???
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creatinine clearance (ml/min) = (140 - age)kg/ 72(serum creatinine)
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How do you change the Cockcroft-Gault equation for women?
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Factor 0.85
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There is a clear decrease in *what* with age?
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Beta-adrenergic response
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Benzodiazepines show a large increase in *what* in the elderly?
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half-life
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Benzo sleep pills are independently associated with what in old people?
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Falls and hip fractures
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What is the prevalent problem with opiates in the elderly?
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Constipation which can become severe
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Which Alzheimer's drug isn't really used now d/t hepatotoxicity?
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tacrine
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Behavioral problems of dementia are treated with what 4 types of drugs?
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1)cholinesterase inhibitors
2)antidepressants 3)stimulants 4)antipsychotics |
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There is a higher likelihood of what 2 side effects in elderly users of ACE-inhibitors?
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renal insufficiency and hyperkalemia
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For what 2 reasons are you more likely to see these side effects in elderly users of ACE-inhibitors?
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1)higher serum levels of the drug
2)concurrent NSAID use |
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This class of pain-killers can elevate the BP and precipitate tx of HTN
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NSAIDs
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TRUE or FALSE: the elderly need higher doses of Ca2+-channel blockers.
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FALSE--they need lower doses
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What 2 side effects of Ca2+-channel blockers are more common in the elderly?
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1)bradycardia
2)conduction block |
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The elderly may experience toxic effects when levels of this inotrope are in the therapeutic range.
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Digoxin!
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Elevated serum levels of digoxin, caused by these 5 drugs, are to blame for toxic effects
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1)amiodarone
2)propafenone 3)quinidine 4)verapamil 5)omeprazole |
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Diuretic-induced loss of these 3 electroytes may cause digoxin toxicity
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1)K+
2)Mg 3)Ca2+ |
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This antiarrhythmic causes side effects more often in the elderly
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Amiodarone
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Renal adjustment is very common when you put elderly pts on this class of drugs
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Antimicrobials
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These 2 types of antimicrobials can precipitate delirium in the elderly.
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Fluoroquinolones and penicillins
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NSAID renal toxicity may cause *this*, leading to edema or CHF exaggeration
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fluid retention
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The risk for *this* classic NSAID side effect is several times higher in elderly pts
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gastric ulceration
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New data suggests that *this* drug may not be as effective as NSAIDs for osteoarthritis.
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Acetominophen
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Rate of ADRs is most closely associated with what?
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Number of drugs taken concurrently
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Failure to anticipate known interactions, like CYP stuff, is what type of error?
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Presriber error
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Failure to take drugs as prescribed is or taking concurrent non-prescription drugs is what type of error?
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Patient error
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These 2 classes of drugs are most frequently involved in interactions and adverse events?
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1)cardiovascular
2)psychotropic |
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According to a 2002 study, what are the 3 most common ADR manifestations leading to hospitalization?
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1)GI
2)metabolic 3)hemorrhagic |
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What are the "Beers drugs"?
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Drug-drug and drug-disease combos that are ill-advised in the elderly.
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What is the "prescribing cascade"?
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Treating side effects of medications with more medicines
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3 examples of the "prescribing cascade"
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1)NSAIDs and HTN
2)Metoclopramide and parkinsonism 3)Anticholinergics and laxatives |