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32 Cards in this Set

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