Geropharmacology

Question 1

What is aging?

Answer 1

the process by which biological systems deteriorate over time culminating in death

Question 2

What are the general characteristics of aging (5)?

Answer 2

1) increased mortality with age
2) physiological deterioration
3) body composition changes
4) reduced ability to respond to environmental change
5) increased vulnerability to diseases

Question 3

What is life expectancy dependent on?

Answer 3

gender and age…as we age, difference between life expectancy of men vs. women decreases

Question 4

What does the ideal survival curve look like?

Answer 4

rectangularization of survival curve - one goal of geriatric research

Question 5

What are the two main factors that have caused changes survival curves (improvements)?

Answer 5

sanitation and immunizations

Question 6

What does prolonging life mean?

Answer 6

increasing the average life span

Question 7

What’s an example of increasing average life span (prolonging life)? What’s a goal of geriatric medicine?

Answer 7

cure disease.

goal: increase healthy life span and maintain functional independence.

Question 8

What does retarding aging mean?

Answer 8

increasing maximum life span

Question 9

What’s an example of increasing maximum life span (retarding aging)?

Answer 9

diet restriction in rats

Question 10

What defines physiological deterioration?

Answer 10

loss of reserve capacity

Question 11

What is the main body composition change that occur with aging?

Answer 11

prevalence of obesity increases with age, but then declines later in life. Obesity decreases active life expectancy

Question 12

What defines reduced ability to respond to environmental change?

Answer 12

loss of reserve capacity

Question 13

Examples of loss of reserve capacity (2)?

Answer 13

during a heat wave, death from hyperthermia is 10-fold higher in older people. body temp response to ice water increases in older people (tolerance decreases)

Question 14

What are four factors of increased vulnerability to disease with age?

Answer 14

1) decreases in T- and B-cell function
2) thymic atrophy
3) diminished reserve capacity
4) increased sucseptibility to infectious diseases (easier to acquire, longer time course, increased mortality)

Question 15

additional thing to consider with increased incidence of diseases (3)

Answer 15

simultaneous diseases, nutritional problems, changing nature of the patient

Question 16

How does absorption change with age?

Answer 16

no change

Question 17

How does volume of distribution change with age?

Answer 17

decreases (higher concentration, increased biological half-life of drug)

Question 18

How does metabolism change with age?

Answer 18

decreased (higher drug concentrations, higher half-lives)

Question 19

How does elimination change with age?

Answer 19

decreases (higher concentration, increased half-life)

Question 20

Old is when…

Answer 20

your friends compliment you on your new alligator shoes and you’re barefoot.

Question 21

What are the general characteristics of aging on drug metabolism (2)?

Answer 21

1) for a given dose of a drug, the resulting blood concentration of that drug will be higher in the elderly
2) biological half-life of a drug is increased with age

Question 22

4 points on pharmacokinetics/pharmacodynamics with age?

Answer 22

1) half-life of most but not all drugs increase with age
2) pharmacodynamic properties of some but not all drugs decrease with age
3) responses to drug therapy are variable in elderly than young
4) titrate to desired response

Question 23

What are some special considerations in aging (7)?

Answer 23

1) multiple diseases
2) multiple physicians and multiple prescriptions (polypharmacy)
3) adverse drug interactions - could be only cause of new symptoms
4) noncompliance (forgetfulness, confusion, multiple and differing dosing intervals, or deliberate-cost, prior experience)
5) Physical disabilities (tremor or motor disability- liquids are difficult, difficulty swallowing large tablets, vision- difficult to read labels)
6) Patient’s environment (financial resources, transportation, who is caregiver?)
7) inappropriate prescriptions (prescribe for disease, not symptoms)

Question 24

Old is when…

Answer 24

“getting a little action” means not having to take any fiber today. If you know what I mean! Hey-ohhhhhh!

Question 25

What are the guidelines for prescribing in the elderly (6)?

Answer 25

1) take a careful drug history
2) prescribe only for a specific and rational indication
3) define the goal of drug therapy. start with small doses and titrate to desired response
4) maintain a high index of suspicion regarding drug reactions and interactions
5) simplify the regimen as much as possible
6) consider the patient rather than just the disease

Question 26

What is personalized medicine?

Answer 26

the customization of healthcare tailored to individual patients

Question 27

What is pharmacogenomics?

Answer 27

drug therapy based on individual patient’s genetic profile

Question 28

1970: long hair.
2013: _____

Answer 28

longing for hair.