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BioScience II > Elderly Pharm-PPt Josh > Flashcards

Elderly Pharm-PPt Josh Flashcards

1
Q

Thankyou teresa and remember……

A

round eyes on the right

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2
Q

Physiology:

Physiologic changes that occur during aging can effec pharmcological responses including what 3 main things

A
  • Plasma protein binding
  • Body content
  • Drug metabolism
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3
Q

Physiology:

what happens to the plasma protein albumin (acidic)

A

decreased

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4
Q

Physiology:

what happens to the plasma protein Alpha1-acid glycoprotein (base)

A

Increased

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5
Q

Physiology: Body content

what happens to lean body mass

A

Decreased

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6
Q

Physiology: Body content

what happens to body fat

A

Increased

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7
Q

Physiology: Body content

what happens to total body water

A

Decreased

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8
Q

Physiology: Body content

recap what are the 3 maoin body content changes that affect how drugs work

A
  • decreased muscle mass
  • increased Body fat
  • decreased total body water
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9
Q

Physiology:Water soluble drugs

what happens to Vd

A

Smaller

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10
Q

Physiology:Water soluble drugs

wha happes to plasma concentration of drugs

A

Higher

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11
Q

Physiology:Water soluble drugs

what will happen to pharmacological effect

A

Increase

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12
Q

Physiology: Lipid soluble drugs

what happens to Vd

A

Larger

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13
Q

Physiology: Lipid soluble drugs

what happens to plasma concentration

A

Lower

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14
Q

Physiology: Lipid soluble drugs

what happens to elimination

A

Prolonged

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15
Q

Physiology: Drug Elimination

in the liver the liver volumes decreases 20-40%, hepatic blood flow decreases 10% per decade, and there is a decrease innate capacity to metabolize drugs. this all leads to what r/t drug metabolisim

A

it decreases

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16
Q

Physiology: Drug Elimination

the renal changes are decreased plasma flow, GFR decreases 6-8% per decade, and renal fxn in reduced, this all leads to what r/t excretion ability of drugs

A

it decreases

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17
Q

Physiology: Summary

name the effects

  1. Decreased vascular volume
  2. decreased protein binding
  3. increased total body lipid stores
  4. Decreased renal and hepatic blood flow
A
  1. high inital plasma concentration
  2. Increased availability of free drug
  3. Prolomnged action of lipid soluble drugs
  4. Prolomged action of drugs dependent on kidney and liver elimination
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18
Q

Pharmacology: Benzodiazepines

what happens to Vd

A

Increased

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19
Q

Pharmacology: Benzodiazepines

what happens to elimination 1/2 life

A

prolonged

20
Q

Pharmacology: Benzodiazepines

Versed- the reuirements are about ___% less

A

50%

21
Q

Pharmacology: Benzodiazepines

Versed- elimination 1/2 life is prolonged from 2.5 to__ hours

A

4

22
Q

Pharmacology: induction drugs

There is a delayed induction time and onset of IV drugs d/t what 3 things

A
  • impaired Myocardial pump
  • Reduced CO
  • Decreased Perfusion of organs
23
Q

Pharmacology: induction drugs: Propofol

requires nearly ___% lower blood levels than a younger pt

A

50%

24
Q

Pharmacology: induction drugs: Propofol

there is a dramatic decrease in what

A

Systemic BP

25
Q

Pharmacology: induction drugs: Propofol

is the a longer or quicker recovery of cognitive fxn

A

Quicker

26
Q

Pharmacology: Inhaled Anesthetics

there is a _____ requirement

A

Reduced

27
Q

Pharmacology: Inhaled Anesthetics

MAC is reduced __-__% perdecade of life after age 40

A

4-6%

28
Q

Pharmacology: Inhaled Anesthetics

what happens to inhalation agent uptake if there is a decreased CO

A

More rapid

29
Q

Pharmacology: Inhaled Anesthetics

the ______ depressamt effects of VAAs are exaggerated

A

Myocardial

30
Q

Pharmacology: Inhaled Anesthetics

there is a prolonged recovery from anesthesia w/ VAAs b/c of what 3 things

A
  • Increased Vd
  • Decreased Hepatic fxn
  • Decreased Pulmonary gas exchange
31
Q

Pharmacology: Opioids

there is a decreased requirement for narcotics b/c of decreased what? (2)

A
  • Vd
  • Protein binding
32
Q

Pharmacology: Opioids

there is a prolomnged elimination 1/2 time leading to what complicatins

A

decreased ventilation

prolonged analgesia

33
Q

Pharmacology: Morphine

what is the metabolite or morphine

A

Morphine-6-glucuronide

34
Q

Pharmacology: Morphine

does the metabolite morphine-6-glucuronide have analgesic properties?

A

Yes

35
Q

Pharmacology: Morphine

the metabolite morphine-6-glucuronide depends on what type of excretion

A

Renal

36
Q

Pharmacology: Sufenta, Alfentanil, Fentanyl

  1. are ____ as potent in elderly pt’s
A

twice

37
Q

Pharmacology: Remifentanyl

is ___ as potent

A

twice

38
Q

Pharmacology: Remifentanyl

there should be a ___% reduction in bolus dose

A

50%

39
Q

Pharmacology: Remifentanyl

there should be a ___-___% reduction in infusion rate

A

30-50%

40
Q

Pharmacology: Muscle Relaxants

what happens to teh respons to both SCh and non-depol

A

nothing it’s unchanged

41
Q

Pharmacology: Muscle Relaxants

what happens to the onset time of NM blockade

A

prolonged

42
Q

Pharmacology: Muscle Relaxants

there is a reduction in clearance and increased elimination 1/2 time. but wait there is one exception… what drug is it?

A

Cisatracurium

43
Q

Pharmacology: Muscle Relaxants

elderly M or F display a prolonged effect from SCh

A

Men

44
Q

Pharmacology: Cardiovascular

the is a ____ response to B-adrenergic agents

A

decreased

45
Q

Pharmacology: Cardiovascular

the sysmpathetic response decreases why?

A

decreased number of sympathetic receptors

46
Q

Pharmacology: Cardiovascular

you may have to _______ the dose for equal CV response

A

Increase

47
Q

Thats it mother……

A

fucker

BioScience II (39 decks)

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