Elderly Care Workshop

Question 1

With elderly people, why must investigations into the true cause of any new symptoms be undertaken before prescribing a new medicine?

Answer 1

It is also important to understand that the elderly seem more sensitive to the side effects of any medicine. This may be due to the pharmacokinetic, pharmacodynamic or ageing changes that are occurring in this age group. When any new symptom presents, iatrogenic disease (symptoms that mimic a disease state but are actually an adverse effect of medicine(s)) must be excluded before prescribing a new item.

Question 2

What are the 10 key issues the influence the effectiveness of medication in the elderly?

Answer 2

1. Preventable adverse reactions.
2. Under-use of medicines.
3. Not taking medicines.
4. Wastage due to inequivalence.
5. Hospital discharge - >changes to medicines.
6. Poor two-way communication between sectors.
7. Repeat prescribing systems
8. Inadequate dosing instructions
9. Access to GP surgery/pharmacy = difficult.
10. under-use of carers.

Question 3

What are the 3 medicine related factors that increase the risk of a negative outcome in care of the elderly?

Answer 3

Taking >4 medicines.
Specific medicines: Warfarin, NSAIDs, diuretics, digoxin.
Recent discharge from hospital.

Question 4

What are the 3 social and personal factors that increase the risk of a negative outcome in care of the elderly?

Answer 4

Low level of home support.
Physical issues: poor vision, hearing and manual dexterity.
Mental state - confusion, disorientation, depression.

Question 5

What is true about most forms of dementia?

Answer 5

They cannot be cured but research is developing.

Question 6

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of

Answer 6

Dementia.

Donepezil
Rivastigmine
Galantamine

Question 7

What are three drugs that can alleviate the symptoms of dementia? what class are they?

Answer 7

Donepezil
Rivastigmine
Galantamine

AChEIs

Question 8

Dementia is a syndrome that is associated with an on-going decline of the brain and its abilities. These include:

Answer 8

Memory 
Thinking
Language
Understanding
Judgement

Question 9

How common is dementia?

Answer 9

570,000 people in England.

Occurs in people 65 and over.

Question 10

What are the 4 different types of dementia?

Answer 10

Alzheimers disease.
Vascular dementia.
Dementia with Lewy bodies.
Frontotemporal dementia.

Question 11

Rivastigmine/ Galantamine

Answer 11

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

Question 12

The type of dementia where small clumps of protein, known as plaques, begin to develop around brain cells disrupting the workings of the brain.

Answer 12

Alzheimers disease.

Question 13

The type of dementia where problems with blood circulation results in parts of the brain not receiving enough blood and oxygen.

Answer 13

Vascular dementia.

Question 14

Donepezil

Answer 14

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

Question 15

The type of dementia where abnormal structures, known as _____ bodies, develop inside the brain.

Answer 15

Lewy body dementia.

Question 16

The type of dementia where the frontal and temporal lobes being to shrink and develops in people under 65.

Answer 16

Frontotemporal dementia. Much rarer than other forms.

Question 17

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

Answer 17

Rivastigmine
Galantamine
Donepezil

Question 18

What advice should be given to patients WRT if they have a fall at home?

Answer 18

1. Try not to panic, stay calm.
2. Do not get up quickly, roll onto your hands and knees and find a stable piece of furniture, such as a chair or bed, to support you as you slowly get up.
3. Rest for a while before carrying on with your daily activities.
4. If you are injured or cannot get up, call for help.

Question 19

What is Hospital 2 Home?

Answer 19

Hospital 2 Home was produced by a task group initiated by Care & Repair England, supported by the Department of Health and the Department for Communities and Local Government

Question 20

What are the 10 ways that medicines can cause falls?

Answer 20

1. Sedation
2. Impaired postural stability
3. Hypotension
4. Drug induced parkinsonism
5. Visual impairment
6. Hypoglycaemia
7. Vestibular damage
8. Hypothermia
9. Confusion
10. Dehydration.

Question 21

What drugs can cause falls by causing sedation/drowsiness?

Answer 21

Antidepressants
Antipsychotics
Parkinsons disease medication

Question 22

What drugs can cause falls by causing impaired postural stability?

Answer 22

Hypnotics
Sleep aids
Benzodiazepines.

Question 23

What drugs can cause falls by causing postural hypotension?

Answer 23

Diuretics

Antipsychotics

Question 24

What drug class can cause drug-induced parkinsonism?

Answer 24

Antipsychotics: increased risk of falls.

Question 25

What drugs can cause visual impairment and thus increase the risk of falls?

Answer 25

Antihistamines

Drugs for urinary incontinence

Question 26

What drugs can cause hypoglycaemia and thus an increased risk of falls?

Answer 26

B-blockers
CCB
Haloperidol
Diabetes medication
Insulin
Quinine