Pharm Topic 9: Geropharmacology

Front 1

Generally what are the 3 most important priorities the elderly want to maintain or improve?

Back 1

1) Physical function
2) Cognitive function
3) Prevention of institutuionalization

Front 2

ADR

Back 2

Adverse drug Rx.
Noxious of unintended Rxs which occur at doses used for prophylaxis, diagnosis, or therapy. Idiosyncratic or may be listed as side effects of the drugs.

Front 3

ADE

Back 3

Adverse drug event. Injury resulting from a medical intervention related to a drug.

Front 4

4 things to consider to reduce risk of ADRs and ADEs in elderly.

Back 4

1) Number of medications
2) Specific medications which are inappropriate for the elderly.
3) Pharmacodynamics
4) Pharmacokinetics

Front 5

3 definitions of polypharmacy

Back 5

1) Prescription, administration or use of more medications than are clinically indicated.
2) 5 or more medications
3) Medication regimen that includes at least one unnecessary drug.

Front 6

5 problems associated with an increase in number of medications

Back 6

1) Increased risk of ADRs/ADEs
2) Severity of ADRs/ADEs
3) Poor compliance
4) Medication errors
5) Increased risk for hospitalization

Front 7

Whats most important factor in predicting adverse drug Rxs?

Back 7

Increased number of drugs, NOT age.

Front 8

Whats most important factor in predicting compliance problems?

Back 8

Increased number of drugs, NOT age.

Front 9

Pharmacodynamics and elderly

Back 9

Sensitivity may be increased (like for sedatives and narcotics),
Or it might be decreased (like for beta adrenergic drugs).

Front 10

Of absorbtion, Distribution, Biotransformation, and Excretion, which one of these is NOT really a concern for the elderly.

Back 10

Absorbtion.

Front 11

Whats more effected by age, phase 1 metabolism or phase 2?

Back 11

Phase 1

Front 12

Indomethacin

Back 12

Antiinflammatory drug not appropriate for elderly b/c of all NSAIDS has most CNS side effects.

Front 13

Muscle relaxants and antispasmodics

Back 13

Are not appropriate for elderly b/c their anticholinergic effects (especially oxybutinin) can cause sedation and weakness. Also the doses are different for elderly

Front 14

Amitriptyline (Elavil)

Back 14

Antidepressant not appropriate for elderly b/c of strong anticholinergic and sedation properties.

Front 15

Benzodiazepines

Back 15

At high doses are not appropriate for elderly b/c have a long halflife and produce sedation increasing risk for falls.

Front 16

Digoxin

Back 16

Is not appropriate for elderly b/c decreased renal clearance can increase risk of toxicity. Should not exceed .125 mgs a day.

Front 17

Meperidine

Back 17

(demerol) Is not appropriate for elderly b/c not effective analgesic for elderly and may cause confusion.

Front 18

Clonidine (catapres)

Back 18

Is not appropriate for elderly b/c has potential for adverse CNS effects.

Front 19

3 things to consider when evaluating benefits of a drug

Back 19

1) Comprehensive geriatric Assesment (CGA)
2) Life expectancy
3) Prioritize outcomes

Front 20

What % of hospitalizations of older patients can be linked to ADEs?

Back 20

30%

Front 21

What side effects are of special importance to the elderly

Back 21

1) Falls
2) Fatigue
3) Weakness
4) Weightloss
5) Wightloss
6) Anorexia
7) Cognitive changes
8) Lightheadedness or dizziness
9) Urinary frequency or incontinence