Lifespan Considerations Flashcards
Category A drug
no risk to fetus
B drug
no risk to animal fetus; info for humans not available
D drug
possible fetal risk (potential benefit vs. risk)
X drug
fetal abnormalities reported & positive evidence of fetal risk in humans. Do not use for pregnant women
Considerations for older adults
- decline in organ function
- drug therapy results in adverse effects/toxicity
- High use of meds
- Noncompliance, non-adherence
Polypharmacy
use of 4 or more medications throughout day
Absorption Gastric pH is Gastric emptying is...bc BF is absorptive surface is
less acidic
slowed bc decreased muscle tone & activity
reduced
reduced
Distribution what happens? (3 things)
- Lower total body water percentages
- Increased fat content
- Decreased production of proteins by the liver, decreased protein binding
Metabolism what happens?
- produces fewer microsomal enzymes
2. Reduced blood flow to liver
Excretion
- Decreased glomerular filtration rate
- Decreased number of nephrons (in kidneys)
DRUGS ARE LESS EFFECTIVE BC OF DECREASED EXCRETION
Confusion, constipation, urinary retention, vomiting, respiratory depression, falls
OPIODS
Edema, nausea, gastric ulceration, bleeding, renal toxicity
NSAIDs
Major & minor bleeding episodes, many drug interactions, dietary interactions
Anticoagulants (heparin, warfarin)
Blurred vision, dry mouth, constipation, confusion, urinary retention, tachycardia
Anticholinergics
Nausea, hypotension, diarrhea, bradycardia, ♡ failure, impotence
Antihypertensives
visual disorders, nausea, diarrhea dysrhythmias, hallucinations, decreased appetite, weight loss
Cardiac glycosides (digoxin)
Sedation, weakness, dry mouth, confusion, urinary retention, ataxia
CNS depressants (muscle relaxants, opioids)
confusion, daytime sedation ataxia, lethargy, increased risk for falls
Sedatives & hypotonics
Electrolyte imbalance, rashes, fatigue, leg cramps, dehydration
Thiazide diuretics
Evaluation (3 things)
a. Observe and monitor for therapeutic effects
b. Observe and monitor for adverse effects
c. Evaluate understanding of drug purpose, dose, dose frequency, adverse effects, special considerations
Physiologic Changes in the Older Adult Patient: Cardiovascular
- Decreased CO= decreased absorption & distribution
2. Decreased BF= decreased absorption & distribution
Physiologic Changes in the Older Adult Patient: Gastrointestinal
- Increased pH (alkaline gastric secretions) =altered absorption
- Decreased peristalsis=delayed gastric emptying
Physiologic Changes in the Older Adult Patient: Hepatic
- Decreased enzyme production= decreased metabolism
2. Decreased BF= decreased metabolism
Physiologic Changes in the Older Adult Patient: Renal
- Decreased BF= decreased excretion
- Decreased function= decreased exertion
- Decreased Glomerular filtration rate= decreased excretion
Drugs requiring special caution/monitoring for this condition: Anticholingerics antihistamines decongestants antidepressants
Bladder flow obstruction
Drugs requiring special caution/monitoring for this condition:
NSAIDs
Aspirin
anti-platelet drugs
Clotting disorders
Drugs requiring special caution/monitoring for this condition:
calcium channel blockers
tricyclic antidepressants
anticholingerics
Chronic constipation
Drugs requiring special caution/monitoring for this condition:
Long acting sedatives or hypnotics
narcotics
beta blockers
COPD
Drugs requiring special caution/monitoring for this condition: Sodium decongestants amphetamines OTC cold products
♡ failure, hypertension
Drugs requiring special caution/monitoring for this condition:
Decongestants
bronchodilators
monoamine oxidase inhibitors
Insomnia
Drugs requiring special caution/monitoring for this condition:
Antipsychotics
Phenothiazines
Parkinson’s disease
Drugs requiring special caution/monitoring for this condition: Sedatives hypnotics opioids CNS depressants muscle relaxants antidepressants antihypertensives
Syncope, falls
