Geriatric Pharm Flashcards
Percentage of persons > 65 on more than 7 meds
82%
How many drugs quantify polypharmacy?
4 or more
Most common causes of death from adverse drug reactions
GI bleeding, intracranial bleeding and renal failure
How does liver metabolism of drugs change in elderly?
decreased hepatic blood flow and first pass metabolism
What are the consequences of decreased liver function in drug metabolism?
there will be greater conc of drug that is active. will require smaller doses
65 clinically significant criteria for potentially inappropriate prescribing in older adults. Overlaps with the Beers criteria
STOPP
Screening tool of older persons’ potentially inappropriate prescriptions
STOPP
Screening tool to alert prescribers to right treatment
START
2 lists of medications to be avoided in older adults. 1 list of medications that should be used with caution
Beers criteria
What medication class should you avoid in elderly due to risk of prolonged hypoglycemia?
sulfonlylureas (glyburide)
What medication class should you avoid in elderly due to increased risk of GI bleeding, PUD?
non cox-selective NSAIDs
Medications that decrease risk of GI bleeding and PUD
PPI or misoprostol
Drug classes that can worsen constipation
antimuscarinics, nondihyropyridine Ca blockers, 1st gen antihistamines
Name the nondihyropyridine Ca blockers
verapamil and diltiazem
What do the following drug classes have in common: SNRIs, SSRIs, antipsychotics
May cause SIADH or exacerbate underlying syndrome
Most commonly omitted medication that a patient would’ve benefited from according to the START study
statins
What should not be considered first choice to treat behavioral and psychological symptoms of dementia?
antipsychotics
What should you avoid doing in an elderly diabetic?
Avoid using medications to achieve A1C < 7.5%
What medications should you avoid in elderly for insomnia, agitation, or delirium?
benzos
What is first choice treatment for elderly patient with insomnia or agitation?
behavioral therapy
If prescribing cholinesterase inhibitors for dementia, what should you periodically asses?
cognitive benefits and adverse GI effects
What should you avoid when starting prescriptions in elderly?
Avoid starting 2 new meds in the same patient at one time
