Drug Therapy in Older Adults

Question 1

Person over the age of 65

Answer 1

Older adult

Question 2

Use of multiple drugs and/or administration of drugs beyond what is clinically warranted.

Answer 2

Polypharmacy

Question 3

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.

Answer 3

Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

Question 4

The extent to which a patient continues to an agreed-on mode of treatment without close supervision

Answer 4

Adherence

Question 5

Physiological changes in geriatric patients that affect their responses to drugs include:

Answer 5

Reduction in total body water and lean body mass. Reduction in kidney and liver mass and function. Reduction in physiological processes that maintain equilibrium.

Question 6

GI changes in older adults that affect drug absorption include:

Answer 6

Decreased surface area of small bowel, slowed gastric emptying, decreased gastric flow, decreased gastric acid production.

Question 7

Changes in older adults that affect drug distribution include:

Answer 7

Increase in fat, decrease in water, decrease in plasm protein

Question 8

Factors that affect metabolism of drugs in older adults include:

Answer 8

Decrease in liver blood flow, decrease in liver mass, decrease in production of drug-metabolizing enzymes.

Question 9

True or False: A decrease in the 1st pass effect leads to an decrease in drug half-life

Answer 9

False

Question 10

Factors that affect drug excretion in older adults include:

Answer 10

Decrease in renal mass and function

Question 11

True or False: Older adults can have a normal creatinine level, but still have decreased renal function.

Answer 11

True

Question 12

Factors that affect Pharmacodynamics in older adults include:

Answer 12

Changes in the number of drug receptors, changes in sensitivity of receptors, decrease in compensatory response to physiological changes.

Question 13

Risk factors for polypharmacy include:

Answer 13

Female sex, multiple health care providers, multiple chronic disease, multiple hospitalizations, and use of herbal therapies and OTC drugs.

Question 14

Adverse drug events (ADEs) include:

Answer 14

Adverse reactions, medication errors, therapeutic failures, adverse drug withdrawal events, and overdoses.

Question 15

ADEs occur more frequently in older adults due to:

Answer 15

physical frailty, multiple chronic conditions, multiple medications, and cognitive impairment.

Question 16

Factors that affect an older adult’s adherence to a drug regimen include:

Answer 16

Taking several drugs at different times. Not understanding why a drug is prescribed. Impairments in memory, dexterity, hearing, and vision. Cost and side effects.

Question 17

When teaching an older adult, make sure to:

Answer 17

1. 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

Question 18

Nursing Interventions related to drug administration in Geriatrics include:

Answer 18

1. 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.