Gériatrie Flashcards
Décrire l’outil CAM
Décrire l’outil ISAR
- Before the illness or injury that brought you to the emergency department, did you need someone to help you on a regular basis? (yes)
- Since the illness or injury that brought you to the emergency department, have you needed more help than usual to take care of yourself? (yes)
- Have you been hospitalized for one or more nights during the past 6 months (excluding a stay in the emergency department)? (yes)
- In general, do you see well? (no)
- In general, do you have serious problems with your memory? (yes)
- Do you take more than three different medications every day? (yes)
Each “yes” response counts as 1 point, for a total score ranging from 0 to 6. A patient is considered at high risk when the score is 2 or more.
Nommer 5 changements a/n cardiovasculaire relié à l’âge avancé
Nommer 6 FR pour expliquer l’augmentation des infections en gériatrie
Nommer les changements pharmacocinétique de la personne âgée
This primarily occurs in the liver via phase 1 metabolism by cytochrome P450 enzymes (oxidation) or phase 2 (conjugation, acetylation, sulfation) reactions.
With advanced age, hepatic blood flow and mass may decrease by up to 40%, which reduces the delivery of medications to the liver and their subsequent metabolism. This decrease in first-pass metabolism improves drug bioavailability and efficacy and increases potential toxicity. Drugs with a high extraction ratio are more dependent on liver blood flow, and the decrease in liver metabolism with age has mainly been related to changes in phase 1 pathways.
Nommer 5 interactions médicamenteuses classiques des personnes âgées
Nommer les principaux médicaments interagissant avec coumadin
et aussi: phénytoine, carbamazépine, ISRS et fibrates
Nommer 6 médicaments à proscrire selon critères BEERS
Promethazine
2Diphenhydramine
3Diazepam
4Hydroxyzine
5Amitriptyline
6Cyclobenzaprine
7Clonidine
8Indomethacin
Nommer 6 des 10 critères de STOPP
1Long-term use of benzodiazepines
2Duplicate prescriptions from the same drug class
3Proton pump inhibitor for peptic ulcer disease at full dose for >8 wk
4NSAIDs in patients with moderate to severe hypertension
5Long-term use of opioids—first-line treatment for mild to moderate pain
6Aspirin without adequate cardiovascular risk
7Warfarin and NSAID used together
8Beta blocker in patients with chronic obstructive pulmonary disease
9Prolonged use of first-generation antihistamines
10NSAID use in patients with chronic renal failure
Nommer 7 types d’abus chez les ainés
Physique / sexuel / psychologique
Abandon / négligence
Financier
Auto-négligence
Nommer 5 théories pouvant expliquer l’Abus des personnes âgées
Nommer 10 FR d’être abuseur ou abusé (abus gériatrique)
For Becoming a Victim
Functional dependence or disability
Poor physical health
Cognitive impairment/dementia
Poor mental health
Low income/socioeconomic status
Social isolation/low social support
Previous history of family violence
Previous traumatic event exposure
Substance abuse
For Becoming a Perpetrator
Mental illness
Substance abuse
Caregiver stress
Previous history of family violence
Financial dependence on older adult
Nommer les 6 questions de l’index de suspicion de l’abus d’ainés
Résumé
Dépendance
Abus physique / psychologique / négligence / financier
Md: éléments suspicieux?
- Have you relied on people for any of the following: bathing, dressing, shopping, banking, or meals?
- Has anyone prevented you from getting food, clothes, medication, glasses, hearing aids, or medical care or from being with people you wanted to be with?
- Have you been upset because someone talked to you in a way that made you feel shamed or threatened?
- Has anyone tried to force you to sign papers or to use your money against your will?
- Has anyone made you afraid, touched you in ways that you did not want, or hurt you physically?
- Doctor: Elder abuse may be associated with findings such as poor eye contact, withdrawn nature, malnourishment, hygiene issues, cuts, bruises, inappropriate clothing, or medication compliance issues. Did you notice any of these today or in the last 12 months?
