2.1 older age Flashcards
how does ageing affect the respiratory system? why do these changes occour?
lung and chest wall compliance decrease with advancing age.
- Total lung capacity (TLC),
- Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and vital capacity are all reduced as people age.
As a result of reduction in elastic support of the airways and leads to increased collapsibility of alveoli and terminal conducting airways.
what are common post operative complications in the elderly?
atelectasis (the collapse or closure of a lung resulting in reduced or absent gas exchange), pulmonary emboli and pneumonia
why can prescription of sedatives be dangerous in the elderly?
as you age, you lose elastic tissue around the oropharynx, which can lead to collapse of the upper way.
sleep or sedative states may result in partial or complete obstruction of the airway.
true or false: a progressive increase in the number of episodes of arterial desaturation during sleep occurs with advancing age.
true
arterial desaturation = decreased pO2 in arterial blood
true or false: elderly patients have decreased sensitivity to CNS depressant drugs and so drug doses need to be modified accordingly.
FALSE.
they have increased sensitivity to CNS depressant drugs = be careful. T
They have reduced hepatic and renal function leading to slower metabolism and elimination of drugs.
why do elderly patients bruise easily?
they have thin skin and fragile subcutaneous blood vessels
why do elderly patients tend to experience hypertension?
large and medium sized blood vessels become less elastic, and therefore become less compliant with age.
result = Raised systemic vascular resistance and hypertension (which may in turn lead to left ventricular strain and left ventricular hypertrophy)
why are elderly patients more susceptible to irregular heart rhythms e.g AF, ectopic beats and heart block?
as cardiac conduction cells decrease in number making these conditions more prevelant
what is arm-brain circulation time and how is it effected with age?
arm-brain circulation time = the time it takes for drugs to reach them brain from the site of injection.
Becomes longer as we age because cardiac output decreases by 3% per decade (due to reduced stroke volume and ventricular contractility)
this means IV anaesthesia is achieved with a smaller dose and is achieved more slowly
why does cardiac output decrease as we age?
decreases by 3% per decade due to reduced stroke volume and ventricular contractility
true or false: plasma protein levels decrease with age
true.
results in decreased protein binding and increased free drug avaliability
how does renal function change with age?
5 things
GFR is thought to decrease by 1% every year over the age of 20 due to the loss of renal cortical glomeruli
ALSO
reduced renal perfusion secondary to reduced cardiac output and atheromatous vascular disease = decrease in renal function.
ALSO
diabetes mellitus is more common = diabetic nephropathy
ALSO
more use of nephrotoxic drugs e.g NSAIDS and ACE inhibitors
ALSO
prostatism in males can lead to obstructive nephropathy and dehydration is common in the elderly (especially in illness)
at what age does metabolic activity begin to fall?
30
what is polypharmacy?
taking multiple medications
what tests can be used to diagnose dementia?
- mental state examination
- pulmonary exam
- blood test
- imaging
its a comprehensive assesment
