Ageing Flashcards
5 domains of the comprehensive geriatric assessment
- Medical
- Psychological
- Functional
- Social
- Spiritual
Tools for measuring frailty
Rockwood Score
- count no. of body systems
- count how many have a deficit
- deficits/no. of systems
Fried Score
- unintentional wt loss
- slow walking speed
- low grip strength
- low physical activity
- self-reported exhaustion
sarcopenia definition
progressive and generalised loss of muscle mass and function related to age
sarcopenia obesity definition
loss of muscle with increased fat
5 symptoms of dying
- pain
- breathlessness
- n +v
- agitation
- secretions
Mx of pain in dying
morphine
Mx of breathlessness in dying
morphine
Mx of n + v in dying
haloperidol (chemical induced n+v)
metoclopramide (stimulates gut)
levomopromazine (broad spec)
Mx of agitation in dying
midazolam
Mx of secretions in dying
buscopan
confusion assessment method
- acute onset + fluctuating course
AND
- inattention
AND EITHER OF
- disorganised thinking
OR
- altered level of consciousness
gold standard for diagnosing delirium
4AT score
components of the 4AT score
- Alertness
- AMT4 (age, DOB, place, current year)
- Attention (months backwards)
- Acute change or fluctuating course
4 or more = potential delirium
drugs causing delirium
sedatives hypnotics anti-depressants drugs with anti-cholinergic effects: codeine, digoxin, furosemide, oxybutinin
Drug Mx of delirium
haloperidol
Drug Mx of delirium in Parkinson’s/LBD
Quetiapine
Mx of delirium if caused by alcohol or BZD withdrawal
Lorazepam
Drugs causing falls
vasodilating drugs (amlodipine, perindopril, tamsulosin)
topical beta blockers
digoxin
what disease do NSAIDs worsen
CHF
what disease do TZD’s worsen
CHF
what disease do anticholinergics worsen
BPH - can cause urinary retention
what group of drugs worsen constipation
CCBs
what drugs lower seizure threshold
neuroleptics
tramadol
quinolones
what drugs worsen asthma and shouldnt be given
b-blockers
aspirin + NSAIDs interaction
increase bleeding risk
warfarin + clarithromycin interaction
clarithromycin increases the anticoagulation effect of warfarin
statin and clarithromycin interaction
clarithromycin increases the effect of the stain, increases the risk of rhabdomyolysis
donepezil + atenolol interaction
hypotension
Tx constipation if stimulation is the issue
senna
Tx constipation if hard stool is the isssue
laxido + lactulose
what food does metronidazole interact with
alcohol
what foods does warfarin interact with
leafy veg
broccoli
cranberry
what drugs interact with K rich foods (e.g. bananas)
ACEi
ARBs
K sparing diuretics (spironolactone)
what food do statins interact with
grapefruit juice
what drugs interact with chicken, turkey, milk, soy and cheese
digoxin
diuretics
drugs with tremor as a s/e
salbutamol
lithium
sodium valproate
clonazepam
