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Biopharmaceutics > Geriatrics > Flashcards

Geriatrics Flashcards

1
Q

What are some of the characteristics that we should be aware of when treating the elderly?

A
  • primary consumers of healthcare services
  • numerous chronic health conditions
  • multiple and complex dosing regimens
  • difference in ADME
  • drug interaction is higher likely
  • difficulty in self administration
  • specialty medications for the elderly
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2
Q

What are some of the diseases to be more conscious of in the elderly?

A
  • coronary heart disease, cancer, alzheimer’s disease, strokes, arthritis, osteoporosis
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3
Q

ADME ____ due to aging

A

decreases

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4
Q

What are some of the reasons by ADME is decreased in the geriatric populations?

A
  • health conditions are highly variable among geriatric populations
  • drug interaction/accumulation/AE prevalent due to multiple regimens
  • mechanisms poorly studies/understood due to limited subject population
  • dose adjustment not strongly recommended
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5
Q

What are some of the GI factors that decrease the absorption time?

A
  • decreases intestinal blood flow
  • increase gastric pH
  • decrease active drug absorption
  • decrease gastic emptying time
    (can possibly improve via formulation manipulation)
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6
Q

Why do we want to avoid multi-dose liquids in the elderly?

A
  • can cause spilling, there can be a lack of control over their fine motor skills
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7
Q

What factors alter the distribution factor in the elderly?

A
  • decreased CO
  • increase in fat and lea body mass
  • decreased serum albumin concentration
  • decreased drug reaching the tissues
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8
Q

What is the difference in the volume of distribution of drugs in the elderly?

A
  • decreased Vd in water soluble drugs
  • increased Vd in lipid-soluble drugs
  • increased prevalence of protein bound drugs
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9
Q

What are the factors that alter the metabolism process in the elderly?

A
  • decreased hepatic blood flow
  • decreased liver size
  • decreased phase 1 metabolism
  • increased incidence of liver dysfunction
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10
Q

What is the effect of altered metabolism on the drugs in the body?

A
  • half life of hepatically extracted drugs increases
  • increased drug accumulation
  • increased pharmacological synergy
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11
Q

What are the factors that lead to an altered elimination rate in the elderly?

A
  • decreased renal blood flow
  • decreased glomerular filtration rate
  • decreased active renal tubular secretion
  • decreased number of functioning nephrons
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12
Q

What is the effect of altered elimination in the body?

A
  • half life of really excreted drugs increases
  • increased drug accumulation
  • increased pharmacological synergy
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13
Q

Baroreceptor reflex in elderly _____

A

decreases

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14
Q

B1 receptor response ____ in elderly

A

decreases

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15
Q

Alpha2 receptor response ____ in the elderly

A

decreases

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16
Q

Glucose tolerance test ____ in the elderly

A

decreases

17
Q

Sensitivity to barbiturates ____ in the elderly

A

increases

18
Q

What is a common effect of taking antihypertensives in the elderly?

A
  • prone to accidental falls
19
Q

The effects of beta blockers ____ in the elderly

A

decreases

20
Q

What is the purpose of coated tablets and why do elderly typically need them?

A
  • the idea is to minimize sticking to the mucosal membranes in the back of the throat
  • elderly often have decreased saliva, so normal tablets stick to the back of the throat
21
Q

What is the absorption effect of transdermal patches in the elderly?

A
  • decreased absorption of transdermal patches in the elderly - their stratum corneum is still there, but there is a lack of moisture to allow for the dissolution of the drug before it goes across the skin
  • decreased water content is the limiting factor that is affecting the movement of the drug across the skin
22
Q

What changes happen to the oral mucous in the elderly?

A
  • drier, increases susceptibility to injury, decreased capillary blood supply
23
Q

What changes happen to the oral muscles in the elderly?

A

decreased bulk and tone, decreased masticatory efficiency

24
Q

What changes happen to the salivary glands in the elderly?

A
  • decreased resting secretory rate, increased viscosity of saliva, decreased enzyme activity of saliva
25
Q

What changes happen o the teeth in elderly?

A
  • loss of tooth, use of denture, decreased chewing ability
26
Q

Are chewable tablets acceptable to give to the elderly? Why?

A
  • no!

- incomplete release of the medication, local irritation and in compliance

27
Q

Are sublingual tablets acceptable to give to the elderly?

A
  • no!

- incomplete release of medication, late onset of action, local irritation and in-compliance

28
Q

Are capsules acceptable to give to the elderly?

A
  • adherence to mucosa, local irritation, in-compliance, esophageal ulceration, choking
29
Q

Are liquid medication acceptable to give to the elderly? Suspensions?

A
  • no to both

- measurement difficulty, variable doses and incompliance

30
Q

What are the oral formulations that we want to avoid in the elderly?

A
  • chewable tablets, sublingual tablets, capsules, liquids/suspensions
31
Q

What is the only drawback of using a granule medication form in the elderly?

A
  • need extra water intake- handle of granules may also be difficult
32
Q

____ and ____ affect more of the geriatric patients than young adults

A

taste and odour

33
Q

What are the components of parenteral administration that we must be aware of?

A
  • mainly for hospitals
  • invasive
  • infection risk
  • risk of in compliance
  • instability
  • complex processing
  • fragile packaging
  • needs sterilization
34
Q

What are the most user friendly products to help the elderly with their dexterity issues?

A
  • big dosage forms
  • easy to open packages
  • single unit doses
  • avoid liquids
35
Q

What are some of the user friendly products that will help patients with their vision issues?

A
  • big prints
  • avoid liquids
  • single unit doses
  • use distinct colors in formulations
  • use distinct formulation forms
36
Q

What are some of the main causes of compliance issues in the elderly?

A
  • memory decline
  • multiple regimens
  • difficulty in self administration
  • taste preferences
  • side effects
37
Q

What are some of the products that can be offered to the elderly to help with the issue of compliance?

A
  • medicine organizer
  • calendar reminders
  • single unit doses

Biopharmaceutics (6 decks)

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