Geriatric assessment powerpoint Flashcards
ASSESSING OLDER ADULTS IN THE
CLINICAL SETTING
Must always consider the patient’s:
___________
Overall condition and ______________
Past medical history
Environment and support system
Current medications
age
functional status
Shared risk factors: older age, cognitive impariment, functional impairment, impaired mobility
Geriatric syndromes: delirium, falls, functional decline, incontinence, pressure
All lead to ________
fraility
Poor health outcomes
Disability, Dependence, Institutionalization, Death
__________are a modifiable risk factor for many geriatric syndromes
medications
2023 AGS BEERS CRITERIA
Identify the potentially inappropriate medication use in older adults
Risks vs benefits
Five Important Tables:
Potentially inappropriate medications (PIMs) that should be avoided
PIM due to drug-disease or drug-syndrome interaction that should be avoided
PIMs to be used with caution
Drug-drug interactions that should be avoided
Medications that should be avoided or have dose reductions based on kidney function
Improve care of older adults by reducing their exposure to PIMs that have an unfavorable balance of benefits and harms compared to
alternative treatments
potentially inappropriate medications
Beers criteria: PIMS
Anticholinergics
Benzodiazpines
Antipsychotics
NSAID
Tricyclic antidepressants
Proton pump inhibitors
Sulfonylureas
Anticholingerics reduced clearance in the elderly, increased risk of __________,confusion,dry mouth, constipation
So avoid!
sedation
Anticholingerics
Diphenhydramine (_________)
Benzotropine (________)
Oxybutynin (_________,_________)
Hydroxyzine (________)
Dicyclomine (__________)
Cyclobenzaprine (_____________)
Benadryl
Cogentin
Ditropan, Oxytrol
Vistaril
Bentyl
Flexeril
Tricyclic antidepressants
Highly anticholingeric, sedating, increased risk of _________–> avoid
orthostatic hypotension
_____________: sharp drop in blood pressure while rising from a seated or reclining position
orthostatic hypotension
Tricyclic antidepressants
Amitriptyline (____________)
Nortriptyline (__________)
Doxepin (____________)
Elavil
Pamelor
Sinequan
Beers Criteria: Benzodiazepines and Z-drugs
Increased sensitivity, decreased metabolism of long-acting agents, increased risk of cognitive _________,delirium, falls, avoid this medication
impairment
Benzodiazepines and Z-drugs
Alprazolam (__________)
Lorazepam (________)
Eszopiclone (___________)
Clonazepam (___________)
Temazepam (__________)
Zolpidem (___________)
Diazepam (____________)
Xanax
Ativan
Lunesta
Klonopin
Restoril
Ambien
Valium
Which of the following drugs contains anticholingeric properties?
Codeine
Cyclobenzaprine
Lorazepam
Eszopiclone
Hydroxyzine
Cyclobenzaprine
Hydroxyzine
Beers Criteria: Antipsychotics
Increased risk of ________in persons with dementia, greater rate of cognitive decline and mortality in persons with dementia, avoid use for behavioral problems or delirium in dementia
Quetiapine (__________)
Risperidone (___________)
Haloperidol (_____________)
Olanzapine (______________)
Clozapine (_______________)
stroke
Seroquel
Risperdal
Haldol
Zyprexa
Clozaril
