Geriatric assessment part 2 Flashcards
So what med should we avoid in older adults? ________ which is a benzodiazepine, phenobarbital some barbiturates, Benadryl
Diazepam
____________(AGS) has the Beers Criteria
American Geriatrics Society
The Beers Criteria identifies keywords ____________(PIMS) use in older adults and it’s the potentially inappropriate and they go through the risk versus benefits of various classes and specific drugs
potentially inappropriate medications
Benadryl is an _________.
anticholinergic
___________ is quetiapine, Seroquel, risperidone
Antipsychotics
Celecoxib and _________ is an NSAIDs
ibuprofen
Why would ibuprofen be potentially inappropriate? ___________
GI bleed
tricyclic antidepressants such as amitriptyline
Proton pump inhibitors like _________
omeprazole
__________are for diabetes. For example like glipizide, glyburide
Sulfonylureas
No older adult should be on glyburide ever!
No older adult should be on glyburide…the reason for that is it has active metabolites and sulfonylureas cause low blood sugars so if you have something that causes hypoglycemia and it has active metabolites so when you have kidney dysfunction and those active metabolites hang around a little bit longer the hypoglycemia is real and dangerous so we would rather use glipizide or glimepiride but in general sulfonylureas we don’t want to use because of the hypoglycemia
Hypoglycemia leads to falls and passing out
______________ is lightheadedness, dizziness, drop in blood pressure when you stand up again leading to falls
orthostatic hypotension
If you have a pain syndrome and you need to give an NSAID give it with a PPI but its short lived and just trying to cover that period of pain and no more
___________ lowers seizure threshold hence we don’t want to use it because we are looking to avoid seizures all together…same thing with tramadol…we talked about cognitive impairment
Bupropion
Benzos are causing to be confused,sedated, which is increasing their risk of falls…in someone who has had a history of falls we want to avoid the following meds because we are trying to prevent another one…its bad enough they have one we certainly don’t want to so our meds listed here all predisposed, increase the risk of falls which obviously opioids
Too much potassium aka ____________leads to arrhythmias so we are going to try to avoid that combo
hyperkalemia
Warfarin going to inhibit clotting factors making it easier for you to ________
bleed
NSAIDs may cause a ___________ or an ulcer further increasing that risk of bleeding
GI bleed
