Elderly-Drugs and Polypharmacy Flashcards
what are the pharmacokinetics changes in elderly
decreased renal function and excretion of drugs
increase in volume distribution of lipid soluble drugs
what are common iatrogenic drug problems
confusion dry mouth constipation blurred vission urianry rétention
what are medically related problems in older people
falls confusion dehydaiton incontinence depression
why do elderly people take more medicine
more acute and chronic diseases
more doctor visits
drugs often given to counteract the side effect of another drug
what are some signs of adverse drug reactions
unsteadiness dizziness unsteady drowsiness falls depression
what are healthcare factors for polypharmacy
no med reivew
think patient expects medicines
prescribes without investigating the problems
what are the worst poly pharmacy drugs
NSAIDS
diuretics
warfarin
how is absorption different in elederly
changes occur that may defect rate but not absorption
this leads to delay of onset
eg GTN spray due to reduced saliva production
how is metabolism different in elderly
reduced due to
decreased liver mass
and decreased liver blood flow
how is distribution different in the elderly
increase in adopts tissue so increase in fat soluble drugs
reduced body water so decrease in water soluble
increased permeability in BBB
decrease in albumin
how is excretion different in elderly
renal functionndecreases
what are the pharmacodynamic changes in elderly
increased pharmacodynamic sensitivity due to
change in receptor binding
decrease in receptor number
eg warfarin has larger anticoagulation
what re principles of prescribing for elderly
start low go slow lower doses and frequency review prescriptions check for side effects consider if drugs are the best option consider compliance issues should not be denied due to age
what is beers crietera
list of inappropriate drugs for older people
what is the purpose of deprescirbing
to reduce, substitute or discontinue a drug
adverse drug reaction
better alternative
not effective
