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DPT 530 > Geriatric Pharmacology > Flashcards

Geriatric Pharmacology Flashcards

1
Q

what are the chances in body composition with aging?

A

dec muscle size and mass

reduction in water and lean muscle

increased body fat %

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2
Q

what are the GI changes in aging?

A

dec fxn of gastroesophageal sphincter

dec gastric acid secretion and emptying

thinning of GI mucosa

dec liver size and blood flow

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3
Q

what are the changes in the genitourinary system with aging?

A

Dec renal mass and glomeruli

changes in bladder

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4
Q

what are the chances in the CV system with aging?

A

fibroelastic thickening

dec baroreceptor sensitivity

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5
Q

what are the neuromuscular and musculoskeletal changes with aging?

A

Dec brain volume

more permeable BBB

dec bone mineral density

dec in homeostatic control

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6
Q

what is the consequence of increased body fat in aging?

A

increased storage of lipid soluble drugs

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7
Q

what is the consequence of decreased plasma proteins in aging?

A

increased water soluble drugs free floating leads to an increase in their effects

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8
Q

what leads to altered drug absorption in aging?

A

dec gastric acid

dec stomach emptying

dec absorbing area

dec motility

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9
Q

what contributes to altered drug distribution in aging?

A

dec water

inc body fat

dec lean body mass

dec plasma proteins

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10
Q

what contributes to changes in hepatic metabolism in aging?

A

dec liver mass

dec liver blood flow

dec enzyme activity

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11
Q

what contributes to changes in renal excretion in aging?

A

dec kidney mass

dec kidney blood flow

dec tubular fxn in nephron

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12
Q

what are the 3 pharmacodynamic changes w aging?

A

1) changes in drug receptor affinity

2) changes in coupling mechanism

3) changes in biochemical events

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13
Q

what are the pharmacodynamic changes w Ca2 channel blockers in aging?

A

inc sensitivity to vasodilation

dec HR and BP

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14
Q

what are the pharmacodynamic changes w beta blockers in aging?

A

reduced beta adrenergic receptors fxn

reduced responses to beta antagonists

dec therapeutic effect w/beta blockers

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15
Q

what are the pharmacodynamic changes w anticoagulants in aging?

A

greater inhibition of synthesis of clotting factors

greater risk of bleeding

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16
Q

what are the pharmacodynamic changes w anticholinergics in aging?

A

impaired cognition in pts w/cholinergic deficit

17
Q

what are the pharmacodynamic changes w bezos in aging?

A

inc postural sway

stronger sedative effects

18
Q

what are the pharmacodynamic changes w anesthetic agents in aging?

A

inc sensitivity to propofol and opioids

19
Q

what are the pharmacodynamic changes w antipsychotics in aging?

A

inc effects

extrapyramidal symptoms, arryhthmias, postural hypotension

20
Q

in aging is the response to beta-agonists increased or decreased?

A

decreased

21
Q

in aging is the response to beta blockers increased or decreased?

A

decreased

22
Q

in aging is the response to Ca2+ channels blockers increased or decreased?

A

increased

23
Q

in aging is the response to loop diuretics increased or decreased?

A

decreased

24
Q

in aging is the response to vit K antagonists increased or decreased?

A

increased

25
Q

in aging is the response to morphine increased or decreased?

A

increased

26
Q

in aging is the response to propofol increased or decreased?

A

increased

27
Q

in aging is the response to antipsychotics increased or decreased?

A

increased

28
Q

in aging is the response to benzos increased or decreased?

A

increased

29
Q

there is a greater variability in drug responses due to changes in …

A

organ fxn

body comp

fragility

comorbidity

pharmacogenetic factors (genotypes)

30
Q

what is polypharmacy?

A

5 or meds taken daily

31
Q

polypharmacy increases the risk of…

A

drug interactions

overdose

toxicity

dosing errors

32
Q

what are characteristics of polypharmacy in older adults?

A

use of meds for no reason

use of duplicate meds

concurrent use of interacting meds

use of contrindicated meds

use of inappropriate dosage

use of drug therapy to Rx adverse drug rxns

33
Q

what are the s/s of common adverse drug rxns?

A

GI symptoms

sedation

confusion

depression

OH

fatigue and weakness

dizziness and falls

anticholinergic effects

extrapyramidal symptoms

34
Q

what are other factors that increase the risk of adverse drug reactions in older adults?

A

comorbidities

lack of proper drug testing w/older subjects

lack of pt education

nonadherence to drug regimen

use of inappropriate meds

35
Q

what is Beer’s criteria?

A

a list of drugs that are likely to make the pt more confused, inc fall risk, inc likelihood of side effects/toxicity

pts should be adequately monitored and benefits should outweigh the risks

DPT 530 (14 decks)

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