April 8th Flashcards
what might happen to lithium levels if an elderly individual is on a low sodium diet
higher blood lithium levels
what might happen to an elderly individual if they’re on cyclosporine and consuming a low sodium diet?
potential for nephrotoxicity
what’s special about grapefruit?
increases absorption of certain medications (antiacids, statin-type drugs). therefore grapefruit juice is prohibited with these kinds of drugs as to avoid liver toxicity
why do the elderly in particuar need to be careful with their diet?
they often take multiple medications which have additive/conflicting effects
what is polypharmacy?
having adverse reactions to taking multiple medications
what is glomerulonephritis?
when there is type 3 hypersensitivity in which immune factors (immunoglobulin G and complement), where drug metabolites are not properly excreted, then there are immune complexes that bind to these metabolites and cause an inflammatory response that causes kidney damage
describe what happens to kidney mass with aging?
30% decrease in renal mass by age 90
what’s the problem with vitamin D when you’re old?
smaller kidney –>the metabolically active form of vit D requires the 1-alpha hydroxylase enzyme that bioactivates vit D into the 1,25-dihydroxy vit D.
this ability to bioactivate goes down, so even if they’re consuming enough vit D, they can still experience a deficiency
what’s special about dehydration with elderly?
increased risk, especially with muse of diuretics and laxatives
in what ways can drugs block actions of vitamins?
- inhibit absorption
- bind them
- enhance their catabolism
- enhance their excretion
- inhibiting their activation
effect of cholestryamine
meant to lower cholesterol (bile acid sequestrants) but can decrease fat soluble vitamin absorption
effect of antibiotics
affects GI and bioavailability of nutrients by inhibiting action of enzymes on epithelium, can damage mucosa’s villi and microvilli
–> nutrient deficiencies when used long-term
effect of anti-inflammatory drugs
- inhibits lactase
- damage gut itself to decrease absorption of fats and micronutrients
effect of laxatives
- loss of fat-soluble vitamins
- faster transit time means less absorption esp for Ca and K
effect of anti-ulcer drugs
- less HCL production
- decreased B12 released from food
- less B12 available for binding with intrinsic factor for absorption
effect of loop diuretics (furosemide)
- increased excretion of thiamin
- cardiac abnormalities
effect of non loop diuretics
- potassium depletion
- risk of cardiac arrhythmias
effect of asprin
increases folate excretion by binding to plasma albumin involved with transport of vitamin to tissues. leads to increased urinary excretion of the now free folate in the blood.
what is diarrhea?
3 or more unformed bowel actions in 24 hours
acute diarrhea lasts for how long?
less than 2 weeks
chronic diarrhea lasts for how long?
3-6 weeks
why are the elderly more susceptible to diarrhea?
diminished immune response and they tend to have more systemic bowel diseases (IBS, colitis) and others like pneumonia, hypothyroidism