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Geriatrics > Introduction > Flashcards

Introduction Flashcards

1
Q

In 2020, adults 65+ made up ___ but accounted for ___ of healthcare spending

A

18%, 43.6%

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2
Q

Care must be ___ for aging people

A

Individualized

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3
Q

What are some other factors affecting health in older age

A

– Genetics
– Socioeconomic status
– Education
– Social engagement and support
– Lifestyle: Exercise, diet, smoking and alcohol
use

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4
Q

What is life expectancy/

A

To what proportion of the maximum age a person
may live

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5
Q

WHat is health span?

A

– Number of years that are spent free from
functional limitations, morbidity, and pain
– Goal of most geriatric models of care -> prolong
the health span

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6
Q

What is ADLs?

A

Activities of daily living

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7
Q

What are IADLs?

A

Instrumental activities of daily living

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8
Q

What are some examples of ADLS?

A
  • Dressing, toileting, eating, bathing, walking
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9
Q

What are some examples of IADLs?

A

Shopping, housekeeping, food preparation, medication
management, financial management

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10
Q

What is an acronym for ADLs?

A

BATTED

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11
Q

What is an acronum for IADLs?

A

SCUM

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12
Q

What ins functional reserve?

A

Body systems generally have capabilities beyond
what is needed for everyday activities

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13
Q

What is impairment in function?

A

demands exceed
functional capacity

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14
Q

Older adults have ___ functional reserve compared to younger adults

A

Decreased

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15
Q

What increases risk of decline of functional reserve?

A

Illness or injury

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16
Q

What is functional decline?

A

Reduction in ability to perform ADLs and
IADLs due to decreased physical and/or
cognitive function

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17
Q

Higher ____ utilization was reported among
those with more chronic medical conditions,
regardless of age

A

healthcare

18
Q

What are tbe absorption changes in older adults? (4)

A

– ↓ gastric acid secretion
– Slower gastric emptying
– Delayed intestinal transit
– ↓ blood flow

19
Q

Generally speaking what is decreased in drug absorption?

A

↓ rate of drug absorption (first-dose, prns)

***No change in extent of drug absorption

20
Q

____ gastric acid secretion may ___ extent of absorption of some medicaitons… (Which meds)

A

Decrease, Decrease, Iron, ketoconazole. calcium

21
Q

How can we combat decreased gastric acid secretion wtih meds?

A

– Empty stomach with iron supplements
– Use citrate form of calcium

22
Q

Utilizing percutaneous absorption what is generally the issue?

A

Aged skin tends to be drier, lower lipid content

23
Q

___ rate of percutanteous absorption of lipophyllic medications

A

Decreased

24
Q

What are examples of lipophyliic medications?

A
  • Fentanyl
  • Testosterone
  • Estradiol
25
Q

What occurs with aging and drug distribution/

A

Changes in body composition

– 25-30% ↑ body fat
– 25-30% ↓ muscle mass/body water

26
Q

What medications may be more prone to building up in an older perosn?

A

– Diazepam
– Amiodarone

27
Q

What happens with highly hydrophilic drugs

A

Less distribution

Lithium
Aminoglycosides

28
Q

What decreased over time that affects distribution?

A

↓ albumin levels in frail/malnourished
older adults ↓ protein-binding of highly-
protein-bound medications:

29
Q

Over time ___ metabolism and elimination compensates for increased free fraction

A

increased

30
Q
  • Liver size and blood flow___ significantly with age
A

decrease

31
Q

Drugs with high ___ extraction will
have increased bioavailability in older
adults

A

first-pass

32
Q

Some___ in Phase I (CYP 450-
mediated) metabolism with aging

A

reduction

33
Q

Longer half-lives – _____ or ___

A

decreased dose requirements
or increase dosing interval

34
Q

There are ____ in phase II metbaolism

A

No changes

35
Q

Medication examples not affected by aging metabolism

A

– Acetaminophen
– Lorazepam, oxazepam, temazepam
– Zaleplon
– Valproic acid

36
Q

What happens with elimination?

A
  • ↓renal size, blood flow, glomerular
    filtration rate, and tubular secretion with
    aging
    – ~10% ↓ GFR per decade after age 30
37
Q

How do we estimate kidney function?

A

Scr alone not reliable, must take into account muscle mass, and age of kidney/function

38
Q

____ blood pressure-lowering response to
beta-blockers

A

↓, decreased

39
Q

___ response to antiepileptic drugs at a
lower serum concentration

A

Increased

40
Q

– _____stiffness of large blood vessels ->
isolated systolic hypertension

A

– ↑, increased

41
Q

d

A

Geriatrics (6 decks)

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