Elderly considerations Flashcards
How can a decline of organ systems change how the body metabolizes anesthetic medications
The basal metabolic rate, and core temperature decrease. The cardiovascular system becomes stiffer as the heart and vessels harden, which can lead to fluid overload and pulmonary edema.
How is the cardiac system affected in the elderly
Increased blood pressure liability, and reduced responsiveness to inotropic and chronotropic drugs (force and rate of contraction)
How is the respiratory system affected in the elderly
The lungs and rib cage get stiffer and less compliant. These patients are at risk for aspiration, pulmonary edema, atelectasis (collapse) and pneumonia
What is the acronym “Frail”
Fatigue, Resistance, Ambulation, Illness, and Loss of weight. 0=robust, 1-2=prefrail, and >3 is frail
Why are anti anxiety medications important when it comes to drug administration
Benzodiazepines decrease metabolism as well as clearance, meaning they will stay in the body for longer. The anesthetic medication doses need to be adjusted appropriately
What cab anticholinergics (atropine) cause and what can be used to prevent such causes
Atropine can cause dysphoria and hallucinations because they cross the blood-brain barrier. Glycopyrrolate does not cross into the brain, so it is best used in elderly patients.
What are the effects of propofol in elderly patients
Propofol causes significant respiratory depression and hypotension. This medication needs to be reduced by 50%
What are effects of ketamine and why is it not recommended in elderly patients
Ketamine increases heart rate and blood pressure, intracranial pressure, and the demand for myocardial oxygen. It also increases tracheobronchial secretions and can increase aspiration risk. Elderly patients with history of heart disease, stroke or hypertension should not have this medication
