Aging Flashcards
What leads to changes in drug distribution in the elderly?
- decreased TBW
- decreased lean body mass
- increased body fat
What changes contribute to mental status changes and pronounced CNS effects in the elderly?
- decreased weight and volume of brain
- decreased blood flow
Why do the elderly have increased incidence of diabetes?
glucose intolerance leads to increased fasting and postprandial glucose
Why do the elderly have an increased incidence of thyroid disorders?
thyroid gland atrophies with age leading to low T3
What does a decreased first-pass metabolism in the elderly lead to?
- increased serum concentration of hepatically cleared drugs
- decreased activation of prodrugs
What does decreased CrCl and GFR in the elderly lead to?
increased bioavailability of renally cleared drugs
What are the I’s of geriatrics?
- immobility
- incontinence
- infection
- inanition
- impaction
- impairment of senses
- instability
- intellectual decline
- impotence
- immune deficiency
- insomnia
- iatrogenesis
What is our mantra?
Any symptom is a medication problem until proven otherwise
What are ADLs?
- bathing/dressing
- toileting
- walking
- eating
What are IADLs?
- handle money
- handle medicine
- use phone
- prepare meals
- travel
- shop
- housework
What drugs can impair bone and muscle integrity?
- glucocorticosteroids
- long-term PPIs
- phenytoin
What can be done to improve bone and muscle integrity?
- Vitamin D
- Calcium
- Bisphosphonates
- resistance exercises
What medications can contribute to dizziness/falls?
- sedative-hypnotics
- antihypertensives
- long-acting benzos
- TCAs
- antipsychotics
- anticonvulsants
What medications contribute to EPS in elderly?
- typical antipsychotics
- Metoclopramide
What medications can contribute to mental status changes?
- anticholinergics
- benzos
- skeletal muscle relaxants
- TCAs
- GI antispasmodics
- antihistamines
