Geriatrics Flashcards
Goals
Maintain Independence
Prevent Disability
Avoid ADE of Treatment
Weigh risk vs benefit of tx
GI Overall
more basic, slowed gastric emptying, slowed GI transit
Skin Overall
thinning of skin and loss of fat
Body comp. Overall
less water, decreased muscle, decreased albumin
Liver Overall
overall effects are decreased, no change in phase II metabolism, decreased ability to do phase I metabolism
Renal Overall
decreased: GFR, CrCl, RBF, renal mass, tubular secretion (worse), also reduced BBB
Calcium
requires acid for proper absorption, elderly should use Ca Citrate
NSAIDs
risk for ulceration (which would be harder to control if it occured) and kidney function issues
Benzodiazepines in the Elderly
“LOT”, lorazepam, oxazepam and temazepam (don’t go through phase I) so these should be used in the elderly
Cockcroft-Gault
{(140-AGE) x weight(kg)} / (72 x SCr)
Other Changes
loss of balance, decr. bone mass, decr. memory, incr. urinary frequency, sensory changes
Medication Management
instruct patient to keep a list with them at all times of the medications they are on (include OTC and herbal meds)
START
screening tool to alert doctors to right treatment
STOPP
screening tool of older persons’ potentially inappropriate prescriptions
Optimal Plan
few meds as possible, EB literature to support use, reduce interactions, proper duration, avoid duplicate therapy
