Exam One medications Flashcards
What drugs increase the risk of falling
CATS MAN
major tranquilizers, anticholinergic drugs, tricyclic antidepressants, corticosteroids, NSAIDs, sedative-hypnotic and anxiolytic
What type of drugs are sedative-hypnotics?
benzodiazepines, barbituates, and ‘z drugs’
Why do benzos, barbiturates, and ‘z drugs’ increase risk of falls
-CNS depression, help induce sleep, etc
What drugs are benzodiazepines
chlordiazepoxide, -lams and -pams
What drugs are barbiturates
end in -barbitol
What drugs are ‘Z drugs’
Zolpidem, zaleplon, eszopiclone
What drugs are tricyclic antidepressants
doxepin, amoxipine, amitriptyline, nortiptyline, trimipramine, etc
Tricyclic antidepressants place our clients at risk of what three things?
- anticholinergic effects
- orthostatic hypotension
- sedation
What are different cardiac medications that increase risk for orthostatic hypotension
ACE inhibitors
ARBs
CCBs
Beta Blockers
Alpha 1 blockers
suffix for ACE inhibitors
-pril
suffix for ARBS
-sartan
suffix for CCB
-dipine
suffix for beta blockers
-olol
suffix for alpha 1 blockers
-zosin
What drugs are corticosteroids?
most end in -sone and -solone
why do corticosteroids increase risk of falls in the older adult
-osteoporosis
What drugs are NSAIDs
ketorolac, aspirin, diclofenac, meloxicam, naproxen, ibuprofen
How do NSAIDs cause falls in the older adult
increases dizziness
What are the hypoglycemic agents
-metformin
-sulfonylureas (begin with gly-)
What med is a stool softener
docusate sodium
What meds are osmotic laxatives?
polyethylene glycol (miralax), magnesium hydroxide, lactulose
What meds are stimulant laxatives>
bisacodyl suppositories, golytely, Senna
Stimulants should be given as a last resort to constipation caused by
narcotics
Polyethylene glycol is an osmotic laxative that increases the risk for
dehydration
what is the bulk forming laxative
psyllium
important considerations with psyllium
-take with full glass of water to prevent bulk formation in the throat
Urge incontinence is often treated with
oxybutynin
is oxybutynin an anticholinergic>
yes
How does oxybutynin work?
relaxes muscles in the bladder increasing urine capacity
Oxybutynin can cause vasodilation which increases the risk of
orthostatic hypotension and slow reaction times
What are the alpha 1 adrenergic antagonists used to treat BPH
-tamsulosin, terazosin, doxazosin (FloMax and Hytrin)
How does tamsulosin and terazosin work?
decreases smooth muscle tone which relaxes the bladder and prostate
Complications of tamsulosin and and terazosin
-hypotension
-decreased / failure to ejaculate
Should alpha 1 adrenergic antagonists be used before cataract surgery?
No ; increases risk for floppy iris syndrome
What should we monitor when our patient is taking tamsulosin, terazosin, and doxazosin?
-BP
-LOC
When should tamsulosin be taken?
30 minutes after a meal
When should doxazosin be taken?
same time each day
Alpha 1 adrenergic antagonists are contraindicated in
liver and renal impairment
What is the 5- alpha reductase inhibitor used to treat BPH?
finasteride
How does finasteride work?
-reduces testosterone which reduces prostate size (also used to fix baldness in males)
How long can it take before we see improvements with finasteride?
6 months
complications of finasteride include?
-decreased libido
-gynecomastia
Client education while taking finasteride
-pregnant women should not touch the medication
-do not donate blood until 1 month after discontinuation
What tests should be monitored while taking finasteride?
liver function tests
How many g / day of carbs do older adults need
130 g (adds brain and nervous system fuel)
Carbohydrates should be what percent of older adult diet?
45-65
Fiber is what kind of carbohydrate
polysaccharide
Carbohydrates and insulin production
-glucose elevates blood sugar –> pancreas releases insulin –> converts glucose to energy
Fiber, which is a carbohydrate, does what four things?
lowers cholesterol, stabilizes blood sugar (decreases abortion rate of glucose), increases ease of BM, and decreases risk of intestinal CA
What may older adults take to increase their fiber
Metamucil and fiber tablets
(foods like sweet potatoes make you feel more full)
Lipids increase function of what organ systems
cardiac and neuro
Omega 3 acids (such as avocoado) decrease risk of
cardiovascular problems
Normal LDL level should be
less than 100
Normal HDL level should be
> 60 males , >70 females
Normal triglyceride level should be
< 200
increased LDL puts patient at risk for?
CAD –> plaque buildup in arteries –> stroke
Male and female caloric needs 51 and older
Male : 2000
Female : 1600
Fruit requirements male and female 51 and older
Male: 2 cups
Female: 1.5 cups
Vegetable requirements male and female 51 and older
Male: 2.5
Female: 2
Grains requirements male and female 51 and older
Male: 6 oz
Female: 5 oz
Protein requirements male and female 51 and older
Male: 5 1/2 oz
Female: 5 oz
Milk requirements male and females 51 and older
Male: 3 cups
Female: 3 cups
Oils requirement male and female 51 and older
Male: 6 tspp
Female: 5 tsp
How much calcium do older adults require in a day?
1200 mg
What medications are dopaminergics and used to treat Parkinson’s disease?
levodopa and carbidopa
Does levodopa potentially speed the progression of Parkinson’s disease?
yes
Side effects of levodopa?
-N and V
-orthostatic hypotension
-dry mouth
-dyskinesia
Nutritional factors of levodopa nurses should be aware of?
-take 1 hr before or 2 hr after meal
-protein heavy meals limit drug absorption
How does combined carbidopa levodopa change the drug?
-carbidopa decreases amount of levodopa is converted to dopamine (more drug available)
-helps with nausea
What is the on off syndrome?
when sx of Parkinson’s (specifically dyskinesia) appear despite treatment
What drug class may be used as the rescue drugs for the ‘off times’ in Parkinson’s?
dopamine agonists
What drugs are dopamine agonists?
pramipraxole, bromocriptine, ropinorole
Can dopamine agonists be used before or with levodopa?
yes
Dopamine agonists such as pramipraxole, bromocriptine, and ropinorole have a high risk for?
hypotension and decreased LOC (also dyskinesias and hallucinations according to UTI)
What drug class may be given to patients with Parkinson’s to control tremors and rigidity?
anticholinergics (benztropine, trihexylphenidyl)
What are catechol - O - methyltransferase (COMT) inhibitors used for when treating Parkinson’s disease?
-increase duration of levodopa by preventing its breakdown
-extends benefit of levodopa for patient
What drugs is a COMT inhibitor?
entacepone
Do COMT inhibitors themselves help reduce symptoms of Parkinson’s disease?
no
Side effects of COMT inhibitors?
diarrhea, hypotension, nausea
-potential to develop dyskinesias and hyperkinesia
Is dark urine considered a normal finding when taking entacepone?
yes
