Ethico-Legal Considerations in the Care of Older Adult / Medications/ Ethical Principles

Question 1

any noxious, unintended, and undesired effects of a drug which occurs at doses in human for prophylaxis, diagnosis or therapy.
* Difficulties in the activities of daily living
* Cognitive changes
* Falls
* Anorexia, nausea
* Weight changes

Answer 1

Adverse Drug Reaction (ADR)

Question 2

It may be related to prescribing, dispensing, administering or monitoring of drug. Root cause: Attributed to human knowldge based deficiencies and a lack of sophisticated systems to support and monitoring drug therapy

Answer 2

MEDICATION ERROR

Question 3

any injury that results in medications used, and this includes both ADRs and medication errors that lead to an ADR.

Answer 3

Adverse Drug Event (ADE)

Question 4

“Any symptom in an elderly patient should be considered a _________until proven otherwise.”

Answer 4

Drug Side Effects

Question 5

Most likely group to visit ED for adverse reactions to drugs among adults?

Answer 5

Those 65 and older. Males (61.5% of visits) and females (60.9% of visits)

Question 6

what the body does to the drug

Answer 6

Pharmacokinetics

Question 7

what the drug does to the body

Answer 7

Pharmacodynamics

Question 8

What is the 2012 Beers Criteria?

Answer 8

Commonly used consensus criteria related to inappropriate medications.

Guideline of drugs to avoid in older adults.

Question 9

Use of antihistamines in older adults?

Answer 9

Avoid 1st generation antihistamin that have anticholinergic properties

Question 10

Anti-parkinsons agents to avoid in older adults because of anticholinergic effects

Answer 10

benztropine and trihexyphenidyl

Question 11

Increase potential for toxicity

Answer 11

Theophylline and Caffeine

Drug-Food Interaction

Question 12

Decrease anti-parkinsonian effect

Answer 12

Levadopa and Clonidine

Drug-Food Interaction

Question 13

Increase risk for bleeding

Answer 13

Warfarin and Aspirin

Drug-Drug Interaction

Question 14

Most common psychiartric disorder in the elderly?

Answer 14

depression

Question 15

Significant problem in older persons and is often associated with depression & dementia.

Answer 15

Anxiety

Question 16

According to the Beer’s list, _ _ _ _ with long
half-lives should be avoided because of the likelihood of
accumulation of the patient drug and its active metabolite,
resulting in increase toxicity

Answer 16

benzodiazepines (persantine)

Question 17

this antidepressant should be avoided in the older patient because of their anticholinergic and sedative side effects profile

Answer 17

tricyclic antidepressants

Question 18

Appropriate indications for antipsychotic prescription include

Answer 18

Schizoprenia, Paranoid States, Symptoms of psychosis such as hallucination and delusions

Question 19

3 D’s that may justify antipsychotic use:

Answer 19

Danger, Distress, Dysfunction

Question 20

committing an unlawful or improper act

Answer 20

Malfeasance

Question 21

performing an act improperly

Answer 21

Misfeasance

Question 22

failure to take proper action

Answer 22

Nonfeasance

Question 23

failure to abide by the standards of one’s
profession

Answer 23

Malpractice

Question 24

disregard to protection the safety
of another person

Answer 24

Criminal Negligence

Question 25

include compassion, equity, fairness, dignity, confidentiality, and mindfulness of a person’s autonomy within the realm of the person’s abilities and mental capacity.

Answer 25

**ETHICS OF CARE**

Question 26

refers to loyalty and **championing of the needs** and interest of others, to educate and informed the patients about their rights and access benefits entitled for them.

Answer 26

**ADVOCACY**

Question 27

Legislated the appropriate use of medications in institutionalized older persons. Use of chemical restraint, Use of unnecessary drugs.

Answer 27

**Omnibus Budget Reconciliation Act (OBRA) 1987**

Question 28

emphasizes respect for human dignity that is demonstrated in daily work.

Answer 28

**CONFIDENTIALITY**

Question 29

refers to using both **fiscal reserves and caregiving resources wisely**, potentially requiring a cost-benefit analysis to facilitate decision making.

Answer 29

**FIDUCIARY RESPONSIBILITY**

Question 30

life referring to the value of life and the right to live.

Answer 30

**SANCTITY OF LIFE**

Question 31

a perception based on personal values and beliefs

Answer 31

**QUALITY OF LIFE**

Question 32

is a feature of integrity concerned with the ability to be true to one’s self while respecting and supporting the values and views of another.

Answer 32

**RECIPPROCITY**

Question 33

between family members and caregivers represent the elderly or assist them in decision-making.

Answer 33

**Actual Conflict of Interest issues**

Question 34

which include those which are not actual conflicts in the course of care but may later become conflicts when the elder patient’s interest diverge from those who provide the care.

Answer 34

Perceived Conflicts of Interest