Ageing Flashcards
pain/SOB
what can you give
morphine
distress
what can you give
midazolam
nausea and agitation
what can you give
levomepromazine
resp secretions
what can you give
buscopam
what is sarcopenia
loss of skeletal muscle mass, stength and function
prevent by doing exercise
vaccinations for the elderly?
one off pneumococcal
one off shingles at 70
annual flu
how do you convert oral morphine to IV morphine
divide oral dose by 3
how do you convert oral morphine to subcut morphine
divide oral dose by 2
how to convert IV morphine to oral
times IV does by 3
which cerebral hemisphere is dominant in most right handed people
left
treatment of choice for those presenting with stroke within 4.5 hours
alteplase
normal/ reduced tone
normal tendon reflexes
poor balance
associated with what sort of disease
cerebellar disease
if somebody has had a fall, when should you use a 24 hr ECG
if there was LOC
name some risk factors for a osteoporotic farcture
old age female steroid use low BMI smoking fam history CKD overactive thyroid liver failure
is delirium poorly recognised
yes
first line to treat delirium
non drug measures
high stepping gait
foot drop
hemiplegic gait
stroke
slow steps
drags leg
alpha blockers such as tamsulosin, are they a risk for postural hypotension
yes
PPI use put you at risk of what
C diff
is MMSE diagnostic for dementia
no. but it can be used in conjuction with a history from a corrobative source
what can mimic dementa
depression
stress
hypothyroidism
B12 deficiency
describe hypothermia
core body temp < 35 degrees
are tendon reflexex normal or abnormal in parkinsons
normal
are people with dementia more likley to have delirium
yes
antiemetic for parkinsons
domperidone
dont use metaclopramide
dose of Iv paracetamol
15mg/kg 4 x daily up to max of 60mg/kg in 24 hours
what is tolteridine
anti-muscarinic used for urge incontinence
what is the SQiD test for?
delirium
its 80% sensitive
“ do you think anne has been more confused lately?”
what drugs should uou avoid in old people if yoiu can?
NSAIDS uneccessary antibiotics bendrofluemethiazide psychotropics PPIs opiates
what fruit/veg reacts with warfarin
green veg( high in vit K)
what fruits interferes with statins
grapefruit
man who said he is losing his memory and doesnt like to go out due to this, low mood and wife died. MMSE score 28/30
depression
old lady was constipated for a while and had pain
best investigation
AXR
which disease has a degenerated NBM
alzheimers
reduced acetylcholine from nucleus basalis of meynert
alzheimers
donepezil and atenolol
drug-drug interaction
BDZ causing memory loss
idiosyncratic effect
treatment of lewy body dementia
Ach-ase inhibitor
phsyiological change in the elderly
increasing heterogeneity
steady state for first order drugs
rate of administration=rate of elimination
dementia in old man, severe behvaioural changes, was embarassing family
fronto-temporal dementia
dementia, also has angina and diabetes, sudden change in memory
vascular dementia
parkinsons disease
started on a new med
falls
postural hypotension
where should you look for drug interactions
BNF
where would you find local prescription info
tayside area formulary
where do you find info on drugs cost effectiveness?
drug tarrif?
medicines compodeim?
patient with BPH, takes decongestant
urinary retention
asthma and beta blockers
bad= bronchoconstriction
what makes constipation worse
calcium
calcium channel blockers
what can lower seizure threshold
tramadol, quinolones, neuropleptics
bananas, ornages, green leafy veg are risj in potassium
what do they interact with
ACEi
ARBs
potassium sparing diuretics
apples chickpeas, spinach, buts, kiwi, brocholie
risk in vit K and E
what do they interact with
warfarin
chicken, turkey, milk, soy, yoghurt
these alter pH
what do they interact with
antibiotics
thyroid meds
grapefruit, oranges, cranberyy, apple
cytochrfome p450
these interact with what?
statins
antihistamines
