geriatrics meds

Question 1

what is the BEERS list?

Answer 1

list of medications likely to cause adverse effects in elderly

Question 2

screening tool of older persons potentially inappropriate prescriptions

Answer 2

STOPP

Question 3

screening tool to alert doctors to right treatment

Answer 3

START

Question 4

as we age, there is a ______total body water

Answer 4

decrease

Question 5

as we age, there is a ______lean body mass

Answer 5

decrease

Question 6

as we age, there is a ______body fat

Answer 6

increase

Question 7

as we age, there is a ______myocardial sensitivity to beta-adrenergic stimulation

Answer 7

decrease

Question 8

as we age, there is a ______baroreceptor activity

Answer 8

decrease

Question 9

as we age, there is a ______cardiac output

Answer 9

decrease

Question 10

as we age, there is a ______total peripheral resistance

Answer 10

increase

Question 11

what parameter is least affected by aging?

Answer 11

absorption

Question 12

Fraction of drug reaching the systemic circulation.

Answer 12

bioavailability (F)

Question 13

what is the volume of distribution?

Answer 13

amount of drug in body/plasma drug concentration

Question 14

Would a highly water soluble drug have an increased or decreased t1/2 in an elderly patient when compared to a younger patient?

Answer 14

less of an increase in 1/2 life than lipid soluble drugs

Question 15

Would the loading dose of a highly water soluble drug be larger or smaller in an elderly patient when compared to a young patient?

Answer 15

smaller

Question 16

do lipid soluble or water soluble drugs have better volume of distribution?

Answer 16

lipid soluble drugs

Question 17

effect of aging on fat soluble drugs?

Answer 17

longer half life

Question 18

what does hepatic clearance rely on?

Answer 18

flow rate to organ x extraction ratio

Question 19

does aging affect phase I enzymes of liver?

Answer 19

yes, reduces activity of cytochrome p450

Question 20

does aging affect phase II enzymes of liver?

Answer 20

NO

Question 21

effects of aging on liver

Answer 21

1. decreased blood flow

2. reduced phase 1 enzymes

Question 22

what is a capacity limited drug?

Answer 22

a drug whose hepatic clearance rate is affected by phase 1 liver enzyme fxn (not flow)

Question 23

what is a flow rate limited drug?

Answer 23

a drug whose rate limiting hepatic clearance step is flow rate

Question 24

how does aging issues with hepatic clearance affect drug dosing?

Answer 24

decrease in maintenance dose req’d

Question 25

what is an index of glomerular filtration rate (GFR)

Answer 25

creatinine clearance

Question 26

why is the cockcroft and gault eqn used?

Answer 26

to acct for the decr muscle mass in elderly patients

Question 27

do hydrophilic or lipophilic drugs have a greater increase in half life in elderly?

Answer 27

lipophilic b/c greater volume of distribution

Question 28

how does rxn to anesthetics change in elderly?

Answer 28

incr sensitivity to anesthetic agents

Question 29

how is the response to CCB altered in elderly?

Answer 29

acute bp response is exaggerated; reduced baroreflex activation with aging

Question 30

elderly have _____local renal production of PG?

Answer 30

increased

Question 31

how do NSAIDS adversely affect elderly?

Answer 31

can diminish the PG that aids in renal blood flow and GFR

Question 32

orthostatic hypotension, sedation,& blurry vision + the dry picture

Answer 32

AE of anticholinergic drugs that are esp pronounced in elderly

Question 33

what classes of drugs have high anticholinergic activity?

Answer 33

• Anticonvulsants, antidepressants, antihistamines, antipsychotics, CV, GI antispasmodics, H2 antagonists, muscle relaxants, PD, urinary antispasmodics, vertigo drugs