Geriatrics

Question 1

Older adult age

Answer 1

-over 60

Question 2

Pharm services in LTC

Answer 2

-review and identify drug therapy probs
-ensure accurate monitoring
-educate patients

Question 3

Meds w fall risk

Answer 3

-sedatives/hypnotics
-antipsychotics/neuroleptics
-antidepressants
-opiods
-loop diuretics
-a-blockers

Question 4

Med probs in older adults

Answer 4

-polypharmacy
-nonadherance
-altered PK

Question 5

Physiologic changes w aging

Answer 5

-dec body water and mass
-inc fat
-dec barorecepter response!!!
-dec HR variability!!!!
-dec hepatic and renal flow
-dec neurotransmitter volume (sensitive to CNS effects)

Question 6

PK of water soluble drugs in aging

Answer 6

-dec distribution
-inc concentration
-Atenolol

Question 7

PK of lipid soluble drugs in aging

Answer 7

-inc Vd
-inc half life
-Rifampin

Question 8

PK of hepatic/renally-cleared drugs in aging

Answer 8

-dec clearance
-inc half-life
-propranolol hepatic
-atenolol propranolol

Question 9

Beers criteria

Answer 9

-65+
-evaluate risk of meds for old ppl

Question 10

Required reading

Answer 10

-Beer

Question 11

Meds considered by Beers

Answer 11

-anticholinergics (cognitive)
-sedatives/CNS effects
-diabetic agents (sulfonylureas)
-meds that might make chronic illness worse

Question 12

How are decisions about recommendations decided

Question 13

Who involved in decision making

Question 14

what types of lit evaluated

Question 15

how does committee decribe quality of eveidence

Question 16

Sedative alternative

Answer 16

-non pharma
-other anxiety tx

Question 17

Sulfonylurea alternative

Answer 17

-shorter-acting agents
-relaxed treatment targets

Question 18

Palliative Care

Answer 18

-after dx of terminal illness
-optimize QOL
-look at symptoms only not life prolonging

Question 19

Hospice Care

Answer 19

-provided at home or facility
-6 months or less to live
-focus on comfort
-

Question 20

Advanced Care Directives (ACD)

Answer 20

-intructions about future tx
-might differ state to state
-health care rep
-psychiatric advance directive
-power of attorney

Question 21

Health care representative

Answer 21

-name somone to make decisions on pt behalf

Question 22

psychiatric advance directive

Answer 22

-sets preferences during periods of mental incapacity

Question 23

Power of Attorney

Answer 23

-financial or health care grants power to others you choose

Question 24

Physician Orders for Scope of Treatment (POST)

Answer 24

-legal doc between pt and physician
-signed and dated
-A: resuscitation pref
-B: med interventions
-C: antibiotics
-D: artificial nutrition