geriatrics Flashcards
an advanced decisions can only be made to refuse things
a. true
b. false
a. true
can refuse treatments
cannot make request
why is tramadol dangerous in the eldery?
it is an opiate but has SNRI qualities
- not renally cleared
- delirium
-
lowers seizure threshold
-impotence
anti-emetic which can be used in parkinsons patients
domperidone
= anti DA activity but does not cross the blood brain barrier, reduces nausea without affecting central DA levels
1st line meds in patients with delirium
haloperidol - quick onset short half life
unless - parkinsons/lewybody dementia/decompensated HF
-> lorazepam
early indicator of parkinsons disease before motor symptoms
olfactory loss/reduced sense of smell
describe the tremor in parkinsons disease
pill rolling tremor, low frequency - 3-5hz
usually asymetric
describe muscle tone in parkinsons
rigidity , increased muscle tone, resistance to passive movement, contributing to stiffness and bradykinesia (slowness of movement)
MMSE of less than what indicates cognitive decline
less than 27/30
what form of dementia are downs syndrome patients at risk of
alzhiemers
key distinguishing features of frontotemporal dementia
- personality and behavior change!!!
memory and visuospatial skills relatively spared
treatment for postural hypotension
fludrocortisone (mineralocortiocoid - increases sodium retention)
why might donepezil be contraindicated in treating alzhiemers ?
it an Actychloinesterase inhibitor
-> can cause or exacerbate bradycardia - causing heartblock or syncope
donepezil
galantine
rivastigmine
are examples of
acetycholinesterase inhibitors
used in alzhiemers
what medication is reccomended when alzhiemers disease progresses despite treatment?
NMDA-receptor antagonists (glutamate)
- memantine
memantine type of drug
an antagonist of the N-methyl-D-aspartate receptor (NMDAR) subtype of glutamate receptor. Memantine is used to slow the neurotoxicity involved in Alzheimer disease and other neurodegenerative diseases
