geriatric pharm ARDs

Question 1

Which pharmacokinetic factors changes least with age

Answer 1

absorption- Amount absorbed (bioavailability) does not changed. Peak conc may be lower and delayed. Exceptions- drugs with extensive first pass effect

Question 2

Which pharmacokinetic factor changes accounts for most change in drug effects with age?

Answer 2

elimination

Question 3

creatinine in elderly

Answer 3

serum creatinine does not reflect creatinine clearance b/c decreased lean body mass leads to lower creatinine production, thus less creatinine to clear

Question 4

risk factors for adverse drug reactions

Answer 4

6 or more chronic conditions, 12 or more doses of drugs/ day, 9 or more meds, prior adverse drug event, low body weight or BMI, age 85 or older, CrCl < 50ml/min

Question 5

sudden withdrawal of amitriptyline…

Answer 5

•may cause a cholinergic rebound syndrome (ie, agitation, borborygmi, diarrhea).

Question 6

sudden withdrawal of clonidine…

Answer 6

may cause rebound hypertension but less likely with dose less than 1 mg daily

Question 7

List drugs that can cause bradycardia

Answer 7

digoxin, verapamil and propranolol.

Question 8

Drugs that can cause weight loss

Answer 8

Theophylline and digoxin may cause nausea and dysgeusia (food tastes bad). Clonidine and amitriptyline cause dry mouth (harder to eat) and photophobia

Question 9

When to start drug Rx for parkinsons disease in elder

Answer 9

•Functional decline: dominant side more affected, interference with ADLs and gait. Meds are associated with side effects and don’t prevent progression