Introduction Flashcards
What are the two prominent theories for aging?
Damage theory
Programmed death theory
What is the focus of damage theory?
Focus on environmental stress that occurs to cells
What are the three pieces of damage theory?
Oxidative stress - increase in amount of or damage from oxidate species in mitochondria or cyp450 functioning
Wear-and-tear - cells are working hard and get worn out
Telomere - cells have a finite number of replication before telomeres shorten, deeming them ineffective at cell division
What does programmed death theory focus on?
Aging has a biological clock
What are the pieces of programmed death thoery
Molecular theory - related to genetics being programmed at certain ages to signal cell death
System decline theory - neuroendocrine (HPA axis) and immune systems decline, they are less adaptive to stress and insults (infectious, cancerous)
What are the leading causes of death?
Accidents Alzheimer's Diabetes Heart dz HTN Stroke
What is the different between frailty and dysfunction
To what degree is a senior able to function without assistance
What are the measurements of functionality?
Activities of Daily Life
Instumental Activities of Daily Life
What is ADL?
Self-care tasks such as personal hygiene, dressing/undressing, eating, toileting, ambulating, transferring from bed to chair
What is IADL?
Activities that allow an individual to live independently; such as light housework, preparing meals, taking medications, shopping for essential items, using the phone, and managing money
What ages are considered elderly?
65-84
What ages are considered very elderly?
85+
What is a geriatric syndrome
Costly and debilitating clinical problems common in geriatric patients which are not neatly categorized as specific disease states or is restricted to certain organ systems
What are common geriatric syndromes?
Frailty Incontinence Delirium Sleep disorders Falls, dizziness, syncope Pressure ulcers, elder mistreatment
What are the I’s of geriatrics?
Immobility Isolation Incontinence Infection Inanition (malnutrition) Impaction Impaired senses Instability Intellectual impairment Impotence Immunodeficiency Insomnia Iatrogenesis
What are diseases that may have atypical disease presentations in older adults?
MI GI bleeds HF URTI UTI
What are the atypical presentations of MI in older adults?
Weakness Confusion Syncope Ab pain Chest pain may be less common
What are the atypical presentations of GI bleeds in older adults?
Altered mental status
Syncope
Hemodynamic instability
Ab pain may be less common
What are the atypical presentations of HF in older adults?
Hypoxia, lethargy, restlessness, and confusions
Dyspnea may be less common
What are the atypical presentations of URTI in older adults?
Lethargy Confusion Anorexia Decompensation Fever, chills and cough may be less common
What are the atypical presentations of UTI in older adults?
Incontinence Ab pain N/V Azotemia Dyspnea, fever and flank pain may be less common
What is the general idea for medication use in elderly populations?
Start low and go slow
What are some types of medication related problems?
Untreated indication Drugs w/o indication Over/under use Improper drug selection Subtherapeutic dose or OD DDIs Failure to receive or take medications
What groups of elderly patients are at greatest risk of ADRs compared with other patients?
Age related biological and PK/PD changes
Multiple chronic diseases
Greater number of meds
What is the PPCP and what does it consist of?
Pharmacist Patient Care Process Collect the data Analyze the data Make a plan Execute the plan Monitoring and Evaluating plan
What are some behavioral strategies to improve medication administration?
Use a pill box
Put/take meds around routine
Use an app/calendar
