Drug Therapy in Older Adults Flashcards
Person over the age of 65
Older adult
Use of multiple drugs and/or administration of drugs beyond what is clinically warranted.
Polypharmacy
A document developed by a consensus panel of 12 experts in geriatric care to aid health care providers in the safe prescription and administration of drugs to older adults.
Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
The extent to which a patient continues to an agreed-on mode of treatment without close supervision
Adherence
Physiological changes in geriatric patients that affect their responses to drugs include:
Reduction in total body water and lean body mass. Reduction in kidney and liver mass and function. Reduction in physiological processes that maintain equilibrium.
GI changes in older adults that affect drug absorption include:
Decreased surface area of small bowel, slowed gastric emptying, decreased gastric flow, decreased gastric acid production.
Changes in older adults that affect drug distribution include:
Increase in fat, decrease in water, decrease in plasm protein
Factors that affect metabolism of drugs in older adults include:
Decrease in liver blood flow, decrease in liver mass, decrease in production of drug-metabolizing enzymes.
True or False: A decrease in the 1st pass effect leads to an decrease in drug half-life
False
Factors that affect drug excretion in older adults include:
Decrease in renal mass and function
True or False: Older adults can have a normal creatinine level, but still have decreased renal function.
True
Factors that affect Pharmacodynamics in older adults include:
Changes in the number of drug receptors, changes in sensitivity of receptors, decrease in compensatory response to physiological changes.
Risk factors for polypharmacy include:
Female sex, multiple health care providers, multiple chronic disease, multiple hospitalizations, and use of herbal therapies and OTC drugs.
Adverse drug events (ADEs) include:
Adverse reactions, medication errors, therapeutic failures, adverse drug withdrawal events, and overdoses.
ADEs occur more frequently in older adults due to:
physical frailty, multiple chronic conditions, multiple medications, and cognitive impairment.
Factors that affect an older adult’s adherence to a drug regimen include:
Taking several drugs at different times. Not understanding why a drug is prescribed. Impairments in memory, dexterity, hearing, and vision. Cost and side effects.
When teaching an older adult, make sure to:
- Check if the adult is wearing glasses and hearing aids. 2. Face the patient. 3. Be respectful. 4. Use large print on light background, 5. Limit distractions
Nursing Interventions related to drug administration in Geriatrics include:
- Monitor lab values. 2. Observe the patient for adverse reactions. 3. Recognize a change in behavior or cognition. 4. Ask patient about all drugs they are taking, including supplements, herbs, and OTCs. 5. Advise patients to use non-child proof caps when appropriate.
