Geriatric Pharmacology Adaptations Flashcards
What are the age-related physiological changes that impact drug absorption?
Slower gastric emptying and reduced blood flow to the gut may slightly delay drug absorption, but this is usually not significant.
How do increased fat stores affect drug distribution in older adults?
Increased fat stores lead to prolonged effects of fat-soluble drugs (e.g., benzodiazepines).
What is the effect of decreased water content on drug distribution?
Decreased water content results in higher drug concentrations of water-soluble drugs (e.g., aminoglycosides).
How do lower albumin levels affect protein-bound medications?
Lower albumin levels increase the free drug concentration of protein-bound medications (e.g., warfarin), leading to a greater drug effect.
What happens to drug metabolism as liver function declines with age?
Liver function declines, reducing drug metabolism, especially for drugs broken down by liver enzymes (e.g., benzodiazepines).
What is excretion?
Excretion is the process of eliminating waste products from the body.
How does renal function change with age?
Renal (kidney) function declines, reducing the elimination of drugs excreted in urine.
What are examples of drugs affected by reduced renal function?
Drugs such as digoxin and aminoglycosides are affected by reduced renal function.
What is a better measure of kidney function than serum creatinine?
Creatinine clearance (CrCl) is a better measure of kidney function than serum creatinine.
Why is creatinine clearance a better measure of kidney function?
Because muscle mass decreases with age.
What is polypharmacy?
The use of multiple medications, often seen in older adults for chronic conditions.
Examples of chronic conditions include hypertension, diabetes, and arthritis.
What are the risks associated with polypharmacy?
Increased risk of drug-drug interactions and drug-disease interactions.
Example: Warfarin and antibiotics can increase bleeding risk.
What is the Beers Criteria?
A list of potentially inappropriate medications for older adults.
What medications are included in the Beers Criteria?
Benzodiazepines, anticholinergic drugs, and NSAIDs.
Benzodiazepines increase fall risk; anticholinergic drugs worsen memory and cause confusion; NSAIDs increase risk of gastrointestinal bleeding and kidney damage.
What is the initial approach to dosing adjustments?
Start low and go slow - Begin with the lowest possible dose and increase cautiously.
What type of regimens should be used for dosing?
Use simplified regimens - Fewer medications and once-daily dosing when possible.
How can medication adherence be encouraged?
Encourage medication adherence - Use pill organizers and reminders.
What should be monitored for in patients regarding drug reactions?
Monitor for adverse drug reactions - These may present as confusion, dizziness, or falls rather than traditional symptoms.
