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PHM704 > Geriatrics - Safe Medication Use & Deprescribing > Flashcards

Geriatrics - Safe Medication Use & Deprescribing Flashcards

1
Q

Potentially Inappropriate Medications

A

anticholinergics
benzodiazepines
antidepressants
NSAIDs

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2
Q

Anticholinergic Effects

A

dry mouth
impaired vision
decreased GI motility
tachycardia
decreased urinary functionality
cognitive dysfunction

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3
Q

Anticholinergic Drug Classes

A

muscle relaxants
TCAs
antispasmodics
antihistamines

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4
Q

Muscle Relaxants - Drugs

A

carisoprodol
cyclobenzaprine
methocarbamol
oxybutynin

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5
Q

TCAs - Drugs

A

amitriptyline
doxepin
imipramine
nortriptyline

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6
Q

Antispasmodics - Drugs

A

dicyclomine
hyoscyamine
propantheline

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7
Q

Antihistamines - Drugs

A

chlorpheniramine
cyproheptadine
diphenhydramine
hydroxyzine
promethazine

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8
Q

Very High ACh Activity - Drugs

A

amitriptyline
atropine
oxybutynin
paroxetine

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9
Q

NSAIDs - Risks

A

4-5x ulcer risk
increased risk of MI and stroke
concern for combo with ACEi and diuretics

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10
Q

Polypharmacy - Consequences

A

ADE
DDIs
cognitive impairment
functional decline
non-adherence
increased healthcare cost
falls

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11
Q

Drugs - Good Candidates for Discontinuation

A

no valid indication
part of prescribing cascade
harm outweighs potential benefit
preventive medications that are unlikely to confer benefit in remaining lifespan
unacceptable treatment burden

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12
Q

Potential for Drug-Induced Harm

A

number of meds prescribed
use of high-risk meds
past or current toxicity

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13
Q

Bisphosphonates - Time to Benefit

A

8-19 months

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14
Q

Statins - Time to Benefit

A

2-5 years

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15
Q

Hypertension Drugs - Time to Benefit

A

1-2 years

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16
Q

Aspirin - Time to Benefit

A

10 years

17
Q

Intensive Glycemic Control - Time to Benefit

A

10 years

18
Q

General Approach

A

consider d/c if life expectancy is less than time to benefit

defer to patient’s values and preferences if life expectancy equals TTB

PHM704 (16 decks)

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