Fraility Flashcards
Older adults who are considered frail need access to beneficial medications for prophylaxis.
What are some examples
Anticoagulants or antiplatelet drugs for atrial fibrillation
Antihypertensives
Statins
Anticonvulsants
Osteoporosis medication
What does the STOPP in the STOPP/START criteria
Stopping medication to minimise adverse events caused by inappropriate prescriptions and polypharmacy
Which of the following medication would you stop in a patient with reduced renal function ? And why?
Loop diuretics
Digoxin 250mcg/day
Diazepam used for over 4 weeks
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
Digoxin
Digoxin over 125mcg/day in patients with reduced renal function increases the risk of toxicity
Which of the following medication would you stop in a patient with ankle oedema without evidence of heart failure ?
Loop diuretics
Digoxin 250mcg/day
Diazepam used for over 4 weeks
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
Loop diuretics
Which of the following medication would you stop in a patient if used over 4 weeks? And why?
Loop diuretics
Digoxin 250mcg/day
Diazepam
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
Diazepam
Long term use of bzp’s increases the risk of falls and sedation
Which of the following medication would you stop in a patient without clear indication ?
Loop diuretics
Digoxin 250mcg/day
Diazepam used for over 4 weeks
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
Omeprazole
Proton pump inhibitors at full therapeutic dose for over 8 weeks without a clear indication needs to be stopped
Which of the following medication would you stop in a patient with moderate-to-severe hypertension ?
Loop diuretics
Digoxin 250mcg/day
Diazepam used for over 4 weeks
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
NSAIDs increase blood pressure
Which of the following medication would you stop in a patient with CKD ?
Loop diuretics
Digoxin 250mcg/day
Diazepam used for over 4 weeks
Omeprazole 40mg for over 8 weeks
Amitryptyline
NSAIDs
NSAIDs are nephrotoxic
What does the START in the STOPP/START criteria
Criteria that helps prevent the omission of necessary and appropriate medication for older patients
What is an example of a drug included in the START criteria for patients with a history of coronary, cerebral or peripheral vascular disease
Antiplatelet agents such as aspirin and clopidogrel
What is an example of a drug included in the START criteria for patients with diabetes and one or more CV risk factors
Statins
What are 2 examples of drugs included in the START criteria for patients that require symptomatic relief in moderate-to-severe COPD
Inhaled B2- agonists
Anticholinergics
What is an example of a drug included in the START criteria for patients with type 2 diabetes
And when would this be contraindicated? Bonus point: why is it contraindicated?
Metformin
Contraindicated in severe renal impairment due to the risk of lactic acidosis
What is an example of a drug included in the START criteria for patients on long term corticosteroids
Bisphosphonates
E.g. alendronic acid
What is an example of a drug included in the START criteria for patients with osteoporosis
Calcium and vitamin D supplements
What is an example of a drug included in the START criteria for patients with depression requiring treatment
SSRI’s
Sertraline
