Elderly care Flashcards
What is a key consideration when prescribing medications for elderly patients?
Elderly patients often have polypharmacy, altered drug metabolism, and increased sensitivity to side effects
What should be reassessed after administering IV fluids to elderly patients?
Fluid status (e.g., BP, urine output, JVP, lung auscultation)
What is the first-line fluid for maintenance in elderly patients unable to eat or drink?
0.9% NaCl + 20mmol KCl per 1L OR 5% Dextrose + 20mmol KCl
What is the recommended rate for maintenance fluids in elderly patients?
25-30mL/kg/day (reduce to 20-25mL/kg/day if frail)
What is the first-line fluid for resuscitation in shock or dehydration in elderly patients?
500mL Hartmann’s OR 0.9% NaCl
What should be done after each bolus of IV fluids?
Reassess fluid status
What is the first-line medication for managing chronic constipation in elderly patients?
Ispaghula husk (Fybogel)
What is the recommended dose for Ispaghula husk?
1 sachet BD with fluids
What type of laxative should be avoided in frail or dehydrated elderly patients?
Bulk-forming laxatives
What is the first-line medication for opioid-induced constipation?
Macrogol + Senna
What is the recommended dose for Macrogol in opioid-induced constipation?
1-2 sachets BD
What should be avoided when prescribing NSAIDs to elderly patients?
Due to renal, GI, and cardiovascular risks
What is the first-line drug for mild pain in elderly patients?
Paracetamol
What is the recommended dose for Paracetamol?
1g QDS
What should be considered if pain is not controlled in elderly patients on opioids?
Consider opioid patch
What is the first-line medication for mild-moderate Alzheimer’s?
Donepezil
What is the initial dose for Donepezil?
5mg OD
What is the preferred SSRI for treating depression in elderly patients?
Sertraline
What is the initial dose for Sertraline?
25mg OD
What should be done with Metformin if eGFR is less than 30?
Stop Metformin
What is a key guideline for prescribing to elderly patients?
Start low, go slow
What should be monitored before prescribing nephrotoxic medications?
Renal function
What is the recommended dose for Oxycodone in elderly patients?
2.5mg PRN
What type of depression medication helps with poor appetite and sleep?
Mirtazapine
What is the maximum duration for using Risperidone in elderly patients?
Max 6 weeks
What should be checked to prevent falls in elderly patients?
Vitamin D levels
What is the first-line medication for Generalised Anxiety Disorder (GAD) in elderly patients?
Propranolol
What is the recommended dose for Propranolol?
10–40mg BD
What type of laxative is Macrogol?
Osmotic
What is a risk associated with Amitriptyline in elderly patients?
Causes falls and confusion
What should be done to reduce polypharmacy in elderly patients?
Regularly review medications
What type of medication should be avoided for sleep needs in elderly patients?
Benzodiazepines
