Geriatric assessment part 2

Question 1

So what med should we avoid in older adults? ________ which is a benzodiazepine, phenobarbital some barbiturates, Benadryl

Answer 1

Diazepam

Question 2

American Geriatrics Society has the Beers Criteria

Question 3

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

Answer 3

potentially inappropriate medications

Question 4

Benadryl is an _________.

Answer 4

anticholinergic

Question 5

___________ is quetiapine, Seroquel, risperidone

Answer 5

Antipsychotics

Question 6

Celecoxib and _________ is an NSAIDs

Answer 6

ibuprofen

Question 7

Why would ibuprofen be potentially inappropriate? ___________, TCAs,

Answer 7

GI bleed

Question 8

tricyclic antidepressants such as amitriptyline

Question 9

Proton pump inhibitors like _________

Answer 9

omeprazole

Question 10

__________are for diabetes. For example like glipizide, glyburide

Answer 10

Sulfonylureas

Question 11

No older adult should be on glyburide ever!

Question 12

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 that already 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

Question 13

Hypoglycemia leads to falls and passing out

Question 14

Orthostatic hypotension is lightheadedness, dizziness, drop in blood pressure when you stand out again leading to falls

Question 15

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

Question 16

___________ 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

Answer 16

Bupropion

Question 17

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

Question 18

Too much potassium aka ____________leads to arrhythmias so we are going to try to avoid that combo

Answer 18

hyperkalemia

Question 19

Warfarin going to inhibit clotting factors making it easier for you to ________

Answer 19

bleed

Question 20

NSAIDs may cause a GI bleed or an ulcer further increasing that risk of bleeding