III: Pediatric and Geriatric Pharmacology Flashcards
_____: adherence to clinical practice guidelines in caring for geriatric patients with multiple comorbidities may have undesired effects
Parsimony
_____: failure to account for impact of multiple chronic diseases on medication safety and efficacy
Danger of silo thinking
Absolute Risk Reduction (ARR) =
Incidence of Control - Incidence of Treated
Cockroft-Gault Equation: _________
(Weight(140-Age))0.85/(72*Cr)
Drugs undergoing _____ metabolism are preferred in older patients
Phase II
For older patients, the ____ dose needs to be decreased for hydrophilic drugs.
loading
For older patients, the ____ dose needs to be decreased for renally excreted drugs.
maintenance
For older patients, the ____ dose needs to be increased for lipophilic drugs.
loading
For older patients, the loading dose needs to be decreased for ______ drugs
hydrophilic
For older patients, the loading dose needs to be increased for ______ drugs
lipophilic
For older patients, the maintenance dose needs to be decreased for ______ drugs
Phase I metabolism or renally excreted
In children, drugs often require ______ maintenance doses compared to adults
increased
In older patients, _____ gastric acid production leads to _____ absorption of weak acid drugs and _____ absorption of weak base drugs.
decreased; decreased; increased
In older patients, drug rate of excretion _____.
decreases
In older patients, extent of drug absorption ______.
does not change
In older patients, Phase __ reactions are preferentially decreased in hepatic drug metabolism
I
In older patients, volume of distribution ______ for hydrophilic drugs
decreases
In older patients, volume of distribution ______ for lipophilic drugs
increases
Initiation of hypertension may increase risk of _____.
falls
Name two medications that do not impair cognition.
docusate, acetaminophen
Number Needed to Treat (NTT) =
100/ARR
Relative Risk Reduction (RRR) =
(Incidence of Control - Incidence of Treated)/Incidence of Control
Renal excretion is more predictable in ______.
children
Which drug (class)? May exacerbate arthralgia/myalgia/osteoporosis (4)
Glucocorticoids, phenytoin, heparin, Vitamin D
Which drug (class)? May exacerbate constipation (4)
CCBs, opioids, antihistamines, antimuscarinic
Which drug (class)? May exacerbate hypotension (5)
beta-blockers, CCBs, vasodilators, diuretics, antidepressants
Which drug (class)? May exacerbate movement disorders (2)
anti-psychotics, metoclopramide
Which drug (class)? May exacerbate overflow incontinence (6)
anticholinergics, antihistamines, TCAs, anti-psychotics, smooth muscle relaxants, alpha antagonists
Which drug (class)? May exacerbate psychomotor retardation (4)
benzodiazepines, antihistamines, anti-psychotics, antidepressants
Which drug (class)? May exacerbate risk of falls (2)
Benzodiazepines, TCAs
Which drug (class)? May exacerbate stress incontinence (1)
alpha-antagonists
Which drug (class)? May exacerbate tinnitus/vitiligo (3)
aminoglycosides, aspirin, ethacrynic acid
Which drug (class)? May exacerbate urge incontinence (2)
cholinergic agonists, diuretics
Which drug class carries the following risks in children? Inhibition of growth via pituitary GH suppression (loss of half an inch)
Glucocorticoids
Which drug class carries the following risks in children? May cause hepatic dysfunction and Reyes Syndrome
Aspirin
Which drug class carries the following risks in children? Modest effect on growth secondary to appetite suppression with weight loss/sleep disturbance
CNS stimulants
Which drug class carries the following risks in children? Permanent staining of teeth; contraindicated for children younger than age 8-9
Tetracyclines
Which drugs should be withdrawn with care?
Clonidine, Amitriptyline
Which statistical parameter is most important in tailoring treatment decisions?
Number Needed to Treat
