ch 9 - pharmacokinetics Flashcards
Study of the movement
and actions of a drug in the body
pharmacokinetics
meds that bind strongly to plasma protein albumin (5)
- ceftriaxone
- ibuprofen
- naproxen
- valproic acid
- warfarin
the process wherein a
pharmaceutical substance can be
eliminated from the body more
easily
biotransformation
how does aging affect biotransformation/metabolism
- decreased liver size
- slower speed metabolism
- med remains in system longer
- increased risk toxicity
what should you assess in older adults to prevent drug toxicity
creatinine clearance rates (GFR)
how does aging affect absorption of meds
- reduced saliva
- delayed stomach emptying
- slowed intestinal motility
- presbyphagia
how does aging affect excretion of meds
-reduced GFR and creatinine clearance
taking how many meds increases risk for morbidity and mortality with drug interactions
5+ meds
potential consequences of polypharmacy
- drug interactions
- difficulties with compliance
- urinary incontinence
- falls
- cognitive impairment
what herbs should not be taken with anticoagulants/warfarin (7)
- echinacea
- garlic
- gingko
- ginseng
- green tea
- red yeast rice
- st johns wort
med combos with high potential for adverse interactions (4)
- ACE and potassium sparing diuretics
- ACE/ARBs and septra
- macrolide antibiotics and calcium channel blockers/digoxin
- warfarin and antibiotics/NSAIDs
3 most common errors with meds and enteral feeding tubes
- incompatible route
- improper prep
- improper admin
3 meds that are high risk meds for adverse drug reactions in older adults
- warfarin
- digoxin
- insulin
3 common aging issues with med use
- polypharmacy
- adverse drug reactions (ADRs)
- interactions
A study that identified potentially
inappropriate medications for use in the
older adult
beers criteria
issues associated with antipsychotic meds (5)
- neuroleptic malignant syndrome (NMS)
- acute dystonia
- akathisia
- parkinsonian symptoms
- tardive dyskinesia (TD)
S+S neuroleptic malignant syndrome (5)
- high fever
- rigidity
- altered mental status
- tachycardia
- pallor
possible adverse event with antipsychotic med: a slow and continuous muscular
contraction or spasm of the mouth,
jaw, face, and neck
acute dystonia
possible adverse event with antipsychotic med: compulsion to be in motion, restlessness, unable to be still, unrelenting desire to move, and feeling “like crawling out of my skin.” The patient is seen pacing, fidgeting, and markedly restless.
akathisia
possible adverse event with antipsychotic med: Shuffling gait, tremor
parkinsonian symptoms
possible adverse event with antipsychotic med: uncontrolled wormlike movements
of the tongue/face, twisting of
limbs/trunk/neck/face/eyes
tardive dyskinesia
S+S adverse drug reactions in older adults (5)
- confusion
- dizziness
- lethargy
- falls
- electrolyte imbalance
