Geriatrics 3 Flashcards
Which factor is unchanged in the geriatric patient?
a. creatinine clearance
b. serum creatinine
c. glomerular filtration rate
d. aldosterone
b. serum creatinine
GFR __________________ after age 40
decreases by 1 mL/min/year
What happens to renal blood flow as we age?
decreased
What happens to renal mass as we age?
decreased
What happens as response to antidiuretic hormone as age?
decreased
What happens as response to aldosterone as we age?
decreased
What happens to creatinine clearance as we age?
decreased
What happens to response to acid load as we age?
decreased
____________ is a poor indicator of renal function in the elderly
Serum creatinine
Renal blood flow decreased by __________ per decade
10%
Decreased renal mass results in
impaired ability to concentrate urine
_____________ is the most sensitive indicator of renal function and drug clearance in the elderly
creatinine clerance
Consequences of reduced GFR in the elderly include
increased risk of fluid overload
decreased elimination of hydrophilic drugs
Decreased aldosterone in the elderly patient leads to
decreased ability to conserve sodium and increased risk of dehydration
The following decrease as a normal response to aging EXCEPT:
a. albumin
b. pseudocholinesterase
c. alpha-1-acid glycoprotein
d,. hepatic blood flow
c. alpha 1 acid glycoprotein
What happens to hepatocellular function as we age?
no change
What happens to hepatic mass as we age?
decreased
What happens to hepatic blood flow as we age?
decreased
What happens to perioperative hepatic function as we age?
decreased
What happens to albumin production as we age?
decreased
What happens to pseudocholinesterase production as we age?
decreased
What happens to alpha-1-acid glycoprotein production as we age?
increased
what happens to phase 1 & 2 reactions as we age?
phase 1- decreased
phase 2- no change
What happens to first pass metabolism as we age?
decreased
Increased alpha 1 acid glycoprotein production leads to ______________ in the elderly whereas decreased albumin production leads to ________ in the elderly
increased reservoir for basic drugs; decreased reservoir for acidic drugs
How does aging affect the pharmacokinetics of anesthetic drugs? (select 2)
a. faster induction with etomidate
b. faster induction with sevoflurane
c. increased volume of distribution of propofol
d. increased volume of distribution of rocuronium
b. faster induction with sevoflurane
c. increased volume of distribution of propofol
Describe the circulation time as we age?
increased
Describe the total body fat as we age?
increased
Describe the lean body mass as we age?
decreased
Describe the plasma protein binding as we age?
decreased
Describe the rate of recovery from volatile anesthetics as we age.
proloned
Describe the surface area to body mass ratio as we age.
increased
Describe IV induction vs. inhalation induction in the elderly patient.
IV induction- prolonged
inhalation induction- faster
The elderly patient has a small volume of distribution for
hydrophilic drugs
Age does not affect pharmacodynamic effects of __________ but the duration of _____________ is increased if _____–
neuromuscular blockers; steroidal NMBs if renal or hepatic clearance is reduced
