Care Of The Elderly Flashcards
How is distribution, metabolism and excretion affected with aging
Distribution
• increase in body mass/weight - higher volume of distribution for lipophilic drugs
• decrease in total body water - less distribution for hydrophilic drugs
Metabolism
• shrinkage of liver and reduced body flow = decrease in drug metabolism
Excretion
• decrease in CrCl
• poor function of glomerular and tubules
^ effects drug excretion
What happens when someone’s with COPD or asthma takes propranolol
Bronchocontriction
What happens if someone is at risk of falls is taking antihypertensives
Increase risk of falls
(Same with amitriptyline)
What happens is someone with bladder output obstruction is taking Oxybutynin
Urinary retention
What happens if someone with constipation is taking iron or ca supplements
Exacerbation of constipation
What happens if someone with a blood disorder takes NSAIDs
Increased bleeding risk
Structured medicine review (SMR)
An intervention to help those with problematic polypharmacy
What are the main drug therapy problems
• adherence
• doses too high
• doses to low
• ineffective drug
• no need for the drug
• need for additional therapy
Define polypharamcy
Take 5 or more medicines
Cause of polyoharamcy
• lack of medication reviews
• lack of communication between prescribed and patient
• muti morbidities
What does medicine optimisation encourage - NG5
• medication reviewed
• medication reconciliation
• professional collaborations
• person centred decisions (patient decision aids)
When reviewing meds we use the STOPP/START tool. What is this?
STOPP
• identifies inappropriate prescribing in the elderly
• decrease the risk of ADRS
START
• helps prevent neglect of appropriate/necessary medicines
Are statins for primary prevention (20mg) beneficial in elderly?
No
True or false - START criteria can identify medications that a patient should be on but is not
True
True or false - digoxin dose of >125mcrg is appropriate in geriatric patients
False