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37 Cards in this Set
- Front
- Back
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What is Creatinine
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product of muscle breakdown
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What is creatine
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used to build muscle (think of little guy (shorter) wants to get bigger
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What is Scr a measure of
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kidney's ability to freely filter creatinine
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What is normal Scr
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0.6-1.2
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What are increase of Scr due to
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reduction in capacity of kidney to eliminate creatinine
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What are decreases is Scr
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common in geriatiric patients, b/c of decreased muscle mass
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What is point of Creatine clearance
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estimate the kidneys ability to clear creatinine and medications (not perfect)
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What is normal CrCl
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100-120 ml/min
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What is equation called to estimate creatine clearance
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Cockcroft and Gault
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What is Cockroft and Gault equation:
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140-age x IBW
------------- x .85=ml/min 72 x Scr |
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What is TWB
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weight in lbs/2.2
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What is IBW
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F 45.5+ [2.3Xinches over 5ft]
M 50 + [2.3Xinches over 5ft] |
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What is ABW
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TBW/IBW if > 1.3
use ABW= IBW + 0.4(TBW-IBW) |
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what is Chem 8 of patient chart to identify Scr
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Salt Buns
Coca Cola creates Glucose and cancer Na Cl BUN K CO2 Scr Glucose and Ca |
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What are units of CrCl
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ML/MIN
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Adverse drug reactions in elderly
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constipation, falls and hip fractures
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Examples of physcial changes in elderly
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decrease visual acuity, decreased reaction time, decrease muscle mass
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How is adsoption altered in elderly
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SAME--but SLOWER--acidity decreased, and decreased GI motility-
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How is distribution altered in elderly
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decrease in serum albumin, more free drug, durg effect more intense
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Are elederly more lipophilic
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yes, more fat, less muscle
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Metabolism in elderly, and elminiation
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decrease liver mass, and drecrease blood flow--elimination--decrease b/c of decreased blood flow to kidneys
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Phase I metabolism in elderly
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CYP450 enzyme is decrased, resulting in decrease metabolism of CPY 450 drugs
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Is Phase II metabolism affected by elderly
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NO
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What causes orthohypotension in elderly
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decreased response of baroreceptors, and decreased water volume
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What drop is systolic blood pressure characterizes orthohypotension
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>20 mmHg
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Patient education of orthostatic hypotension
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get up slowly, and carefully, maintain water, adn salt intake, eat smaller and more frequent meals, and home safety
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Why should elderly eat smaller and more frequent meals
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b/c blood goes to stomach
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Do drugs have an increased half-life in elderly?
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YES
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What are 3 drugs types contraindicated in elderly for othostatic hypotension
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antihypertensives, tranquiliezes, and antidepressants
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What are anticholinergic effects
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no see, no pee, no spit, no poop
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What is most important pharmokinetic change in elderly
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is reduced renal elmination
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What is pharmokinetics
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ADME, what you body does do the drug
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What is pharmodynamics
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study of what drugs do to your body, and how they do it
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What is adsoprtion
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movement of drug from site of administrationt to blood
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What is distribution
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movement of drugs throughout body
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What is metabolism
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enzymatic alteration of drug structure
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What is excretion
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removal of drugs from the body
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