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18 Cards in this Set
- Front
- Back
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what physiological changes are associated with aging?
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1. increased fat
2. decreased bone 3. decreased muscle mass 4. decreased water content |
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what happens to creatinin clearance with age?
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it decreases.
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what is the order of importance of the organ system in old people?
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kidney>liver>CNS>GI
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what happens to drug metabolism in liver due to aging?
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decreased Phase I metabolism
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which drugs are metabolized using phase I?
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long acting benzos like chlordiazepoxide, diazepam,flurazepam, barbiturates, dilantin, phenytoin
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what happens to receptor density and sensitivity in old ppl?
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receptor density goes down and sensitivity goes up
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which anti cholinergic drugs are not advisable for old ppl?
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Diphenhydramine, other sedating antihistamines, Narcotics like Mepiridine, dicyclomene, muscle relaxers like scalaxone and cyclobenzaprine, darifenacin for urinary retention
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name specific drugs that can bind to plasma proteins and thus a cause of concern in the elderly
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Phenytoin, Carbamazepine, Barbiturates, Warfarin
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what is the formula to calculate creatinine clearance?
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(140-age) x weight(Kg) / serum creatinine x 72
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state some main drugs eliminated by kidney?
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Penicillin, Aminoglycosides, Fluoroquinolones, H2 blockers, ACE inhibitors, Metformins, Bisphosphonates.
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when is there a risk of aspiration pneumonia?
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when there is dysphagia and H2 blocker therapy with decreased acidity in the stomach.
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which anti spasmodic is preferred in old ppl? why?
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Solifenacin, more selective for muscarinic receptors in the bladder and less likely to cross the BBB.
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which classes of anti-cholinergic drugs would you avoid?
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1. Phenothiazines
2. Atypical antipsychotics like Quetiapine, Olanzapine etc 3. tricyclic anti depressants like Imipramine and amitriptyline |
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which SSRI's can you use to treat depression?
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Sertraline, Escitalopram, citalopram
duloxetine can be used if chronic pain is comorbid with depression. |
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which SSRI's should be avoided in old ppl?
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Fluoxetine and Paroxetine
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what three problems can chronic use of NSAIDs cause?
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1. bleeding
2. confusion at high dose 3. blocks prostaglandin mediated vasodilation of the renal tubule leading to hypertension which can precipitate heart failure. |
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what are the side effects of beta blockers?
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1. precipitation or exacerbation of CHF
2. masking of hypoglycemia 3. development of hypotension 4. masking of hypothyroidism 5. reduction in exercise capacity 6. exacerbation of chronic lung disease 7 depression 8. memory loss 9. Arthropathy |
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which beta blockers should be used in elderly?
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atenolol and metoprolol
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