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38 Cards in this Set

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  • Back
With Geriatric drugs, more than 7 drugs, thats a what?
a red flag.
Research shows this causes a drug reaction including herbal and at a as needed basis. So MD & nurse know they MUST have a reason to give a drug. q
Organs in old people start to fail. kidneys and lungs can't metabolize like they could. drugs affect taste. SSRI or seritonin anti depresent causes ?
anoxiea. So what?
So if pt is on Paxil or Prosac, these SSRI cause anorexia in elders.
drugs that lower Blood pressure will cause what in a elder?
confussion. We know Actelcolone helps us not get confused.
The chemical compound acetylcholine, often abbreviated as ACh, was the first neurotransmitter to be identified. It is a chemical transmitter in both the peripheral nervous system (PNS) and central nervous system (CNS) in many organisms including humans. Acetylcholine is the neurotransmitter in all autonomic ganglia.
what kind of effect does antihistomines have?
anti collenergic side effects like dry eyes, mouth, constipation, urinary retention, etc. Antihistomines really affect dementia pts, they will feel a threat, can strike out at you
So any anti histomine that causes a dementia elder to dry out is called what?
anti collonergic
Drugs on elders have action that has to do with absorption. what is this?
Decrease in GI blood flow and motility.
motility (mō-tĭl′ĭ-tē) The power to move spontaneously.
what is polyphamacy?
the concurrent use of many medications. Increases the risk for adverse reactions.
Old people have problems with drugs with:
absorption, distribution, metalbolism, and excretion
Age related changes from drugs include:
dry oral cavity/mucous membran
decreased cir. to lower bowel
lower body temperatures
decreased tissue elastiticty
reduced muscel mass and activity
decreased pain sensation
decreased cardiac effeciency
less gastric acid
increase in adipose tissue
reduced serum albumin levels
reduced # of working nephrons
reduced blood flow
what further fucks up the management of polypharmacy for seniors?
senirors don't take their meds correctly, not at the right time, further screwing things up
so seniors don't understand or can read their medication directions.Great. Now problems with absorption. What has a decrease in _____blood flow and motililty (delay peak effects of oral drugs)?
Absorption in old people in the GI is decreased b/c of slower blood flow and motility
what else slows down the GI from absorbing drugs like younger people can?
old people have a compromised mesnteric circulation. It lengthens absorption time and may increase amt absorbed too, throwing the equation off
Whats wacked out with old people's distribution for drugs?
the adequacy of the circulation system itself!
there is reduced plasma albumin-increased risk of toxicity
there are changes in body composition/reducing total body water. this has inpack
what happens in regards to drugs half life in old people?
drug half life is affected by old people kidney function. Altered filtration, decreased plasma volume b/c of dehydration.
what is the best index of renal function in elders?
Creatinine Clearence test. better than serum creatinine.
what is creatinine?
a byproduct of muscle metabolism. Used to detect renal failure in old people
What is the Glomeareal Filtration Rate?
glomerular filtration rate (GFR) The rate of urine formation as plasma passes through the glomeruli of the kidneys.
what is the Creatinine forluma? remember for women its the total X 0.85
140-age X KG / 72 X serim Creatinine!
Concerning using diuretics, what _____ is related to alteration in cardiac output?
edema is related to alteration in cardiac output
Diruetics causes dehydration in elders. what does this also cause?
hepatic changes
electrolyte imbalance
blurred vision
decreased tolerence to contact lenses
what is Digoxin and what is it to do w/ seniors?
the drug is only slighty metabolized SO some it always collects and builds up in the kidneys(I think) anyway this causes hypokalemia... An abnormally low concentration of potassium in the blood.
what are the symptoms of hypokalmeia?
potassium levels down
irregular heart beats
So what is Digoxin?
digoxin (dĭ-jŏk′sĭn) The most frequently prescribed digitalis glycoside. It may be used orally or intravenously to treat patients with congestive heart failure, atrial fibrillation, atrial flutter, and supraventricular tachycardias.
So what about an elder using Digoxin and other drugs. What should we be concerned with or look for?
using Digoxin with Lasix (diurectic) or other drugs that make patient excreat potassium SO use a potassium sparing diuretic instead!
what about antacids and elders?
old have a delayed gastric emptying called dyspepsia. dyspepsia. Upper abdominal discomfort, often chronic or persistent, colloquially referred to as “indigestion.”
what happens when old folk take an antiacid with a oral anticoagulant?
enhanced bleeding!
what happens when senior takes antacid with amphetimines?
there is excessive simulation
what about antacids mixed with narcotics?
excessive depression
what about antiacids mixed with iron supplements?
insoluable compound unable to be absorbed!
what if you mix narcotics with analgesics? (a mild pain med w/ a strong one?)
increased sedation
lower doses due to decreased renal clearence or hepatic clearence (kidneys/liver can't metabolize so you don't get it all
then there is the old foggie that will mix a herval with his other prescription. what is this about?
knowledge deficit
how can a nurse help with all this?
easy to read meds
what foods to take/avoid
restricted activities
side effects and what to do
storage issues
expiraton dates
whats the problem with grape fruit juice?
grapefruit juice inhibits P450 which is an emzyme used to break down drugs (metablize)
what are GI changes for seniors?
loss of peristolisis
tooth loss
loss of taste buds/use salt/sugar to taste foods
loss sense of smell
dilation of esophagus which is an aspiration risk
gag relfex is weakened
what about nutrition issues?
dentures don't fit anymore b/c of bone loss, need refitting
decreased ability to feed themselves
what about anti parikinson drugs used with other drugs?
there is a problem with decreased acedilcolone and dopamine!
Tagament has cimetidine. Anyone over 50 has this. P450 is in liver. So what?
a drug that depends on P450 to metabolize a drug BUT your P450 levels are low b/c of other drugs or naturally, your giving this person trouble. So now they give Zantac instead of Tagament.
Cytochrome P450 is a family of the body's more powerful detox enzymes. Over 60 key forms are known, with hundreds of genetic variations possible, producing a wide variety of susceptibility to specific toxins. As the saying goes, "One man's meat is another man's poison".
what are dosages in elders based on?
weight. esp if very old. not on age, but weight