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PHRM 844 > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

BEERS criteria applies to who?

A

65+ except on hospice

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2
Q

avoid ___ non valvular afib or VTE

A

warfarin

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3
Q

anithhrombics to avoid

A

aspirin, warfarin (high)
rivaroxaban (moderate)

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4
Q

diabetes avoid:

A

sulfonylureas
short acting insulin (only)

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5
Q

DOAC to avoid

A

rivaroxaban

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6
Q

DOAC to caution

A

dabigatran

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7
Q

ADP receptor antag to caution

A

ticagrelor
prasurgel
(Bleeding risk over 75)

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8
Q

SGLT-2s cautions

A

increased risk urinary infectuions and euglycemic DKA

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9
Q

older adults make up __ of US population but use ___ of the meds

A

13%, 33%

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10
Q

older adults have a greater risk of dying from____

A

chronic conditions rather than acute

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11
Q

LTC communication form

A

physician action report, between providers and pharmacy

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12
Q

LTC pharmacy pros

A

flexible schedule
independent work
multiple disciplines
clear role of pharmacist

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13
Q

LTC pharmacy cons

A

travel time significant
written communication
limited patient interaction

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14
Q

consultant pharmacy services LTC

A

review meds every month or three months

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15
Q

healthy aging

A

maintaining functional ability to enable wellbeing in older age (capabilities to engage in something one values)

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16
Q

goals for care

A

indepenence
avoid institutionalization
good quality of life
functional ability

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17
Q

medications with risk of falls

A

sedatives/hypnotics
antipsychotics
antidepressants
opioids
loop diuretics
alpha blockers

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18
Q

aging is not a barrier to adherence (t/f)

A

TRUE, there are so many barriers to adherence

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19
Q

what happens to body water with age

A

decrease

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20
Q

what happens to lean body mass with age

A

decrease

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21
Q

what happens to body fat

A

increase

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22
Q

what happens to barroreceptor response

A

decrease

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23
Q

what happens to heart rate with age

A

not as much variability

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24
Q

what happens to hepatic and renal blood flow

A

decrease

25
Q

what happens to neurotransmitter volume

A

decreased, more sensitive to CNS adverse effects

26
Q

what happens to bioavailability of drugs

A

stays the same

27
Q

what happens to water soluble drugs (give example of drug)

A

decreased Vd so increased concentration (atenolol)

28
Q

what happens to lipid soluble drugs (give drug)

A

increased Vd and increased half life (rifampin)

29
Q

what happens to hepatically and renally cleared drugs?

A

decreased clearance and increased half life (atenolol and propanolol)

30
Q

can we predict the rate of change in pharmacokinetics?

A

no, unique to each person

31
Q

what is the Beers criteria

A

potentially inapropriate med use in pts 65+, made by American Geriatric Society, updated every 3 years

32
Q

recognize new symptoms as

A

potential adverse reactions

33
Q

when to do pallative care?

A

after diagnosis of terminal illness, disease is not responsive to curative treatment or there is no treatment

34
Q

pallative care med considerations

A

only want to optimize QOL
stop meds not improving QOL
focus on symptoms only

35
Q

Hospice care life expectancy

A

6 months or less

36
Q

what are Advanced Care Directives

A

instructions about future medical care and treatment, don’t take away your right to make current decisions

37
Q

what do advanced care directives include? (three things)

A

health care representative
psychiatric advance directive
power of attorney

38
Q

what is a healthcare representative

A

makes decisons for you if you are unable

39
Q

what is a psychiatric advance directive

A

sets preferences like mental illness when you cant

40
Q

what is power of attorney

A

grants power to others for financial

41
Q

POST

A

physicain orders for scope of treatment
- agreement between patient and physician, MUST BE SIGNED AND DATED TO BE VALID

42
Q

what does a POST include?

A

resusitation pref
medical interventions (dialysis)
antibiotics
artifical nutrition

43
Q

geriatrics prefer what terms

A

older adult over elderly

44
Q

what receptors support detrusor relaxation/filling

A

beta 3

45
Q

age related changes to bladder and urethra

A

decrese bladder capacity/elasticity
increase spontaneous detrusor contractions
decrease sphincter compliance

46
Q

what is overflow

A

urethral blockage
bladder cant empty properly

47
Q

what is stress incontinence

A

relaxed pelvic floor, increased abdomnial pressure

48
Q

medciation causes of frequency

A

diuretics
alpha antagonists

49
Q

medication causes of urgency

A

acetylcholinesterase

50
Q

medication causes of overflow

A

alpha antagonists
antihistamines

51
Q

overflow treatment

A

alpha antagonists

52
Q

urge treatmemt classes

A

anticholinergic/antimuscarinic
beta 3
combination

53
Q

urge meds

A

oxybutinin
tolterodine
mirabegron
-enacin

54
Q

how long does it take to see effects of urge meds (anticholinergic/antimuscarinic)

A

2-4 weeks

55
Q

anticholinergic/antimuscarinic side effects

A

dry mouth, constipation, fatigue, confusion

56
Q

stress meds

A

topical estrogen, duloxetine 40mg BID, alpha agonists

57
Q

overflow meds

A

tamsulosin 0.4mg
doxazosin 1-4mg

58
Q

neurogenic tx

A

scheduled voiding
meds dont rlly want

59
Q
A

PHRM 844 (16 decks)

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