Geriatric Phramcotherapy

Question 1

How do we define older adults?

Answer 1

Over 60

Question 2

Are older adults at a greater risk of chronic diseases or acute disease?

Answer 2

Chronic

Question 3

Which medications can increase the risk of falling?

Answer 3

-Sedative/hypnotics
-Neuroleptics/antipsychotics
-Antidepressants
-Opioids
-Loop diuretics
-Alpha-blockers

Question 4

What are some pharmacokinetic changes with aging?

Answer 4

-Slower Tmax
-decrease Vd and increase concentration of water soluble drugs
-Increase Vd and increase half life of lipid-soluble drugs
-Decrease clearance and increase half life of hepatically cleared drugs
-Decrease clearance and increase half life of renally cleared drugs

Question 5

Is urinary incontinence more common in males or females?

Answer 5

Females

Question 6

Age-related changes to the bladder and urethra

Answer 6

-Decrease in bladder capacity and elasticity
-Increase in spontaneous detrusor contractions
-Decrease in sphincter compliance
-These may result in an inability to urinate or postpone urination

Question 7

What happens in the body to cause urge or overactive bladder?

Answer 7

Hyperactivity of detrusor muscles which cause unpredictable voiding

Question 8

Symptoms of urge or overactive bladder

Answer 8

Urgency
Frequency

Question 9

Drug causes of urge or overactive bladder

Answer 9

Acetylcholinesterase inhibitors for Alzheimers disease

Question 10

How do you describe stress urinary incontinence?

Answer 10

-Incontinence of the urethral sphincter with abdominal pressure
-Most often small volume accidents
-More common in women
-Risk factors are multiple childbirths and lack of estrogen
-Can be exacerbated by alpha-antagonists

Question 11

How do you describe overflow incontinence?

Answer 11

-Results from outlet obstruction or inability to or uncoordinated detrusor constriction
-Most commonly from BPH

Question 12

Symptoms of overflow incontinence

Answer 12

-Abdominal discomfort or pain
-Frequency
-Feeling the need to void shortly after voiding

Question 13

How do you describe neurogenic bladder?

Answer 13

-Disruption in neurologic innervation of the bladder
-Inability or uncoordinated detrusor constriction
-Small urine volume when voiding and small volume accidents
-Loss of feeling that bladder is full
-Dribbling of urine
-Frequency and urgency
-Increases risks of UTI
-Increases risks of kidney stones

Question 14

Possible causes of neurogenic bladder

Answer 14

-Stroke
-Neuropathy
-Spinal cord injury

Question 15

How do you describe functional incontinence?

Answer 15

Inability to get to the bathroom in a timely fashion