Medications

Question 0

The higher incidence of drug reactions in older adults is caused by?

Answer 0

Impaired drug metabolism due to decreases in Glomeruler filtration rate and hepatic clearance changes in volume distribution of drugs and individual variation in sensitivity to drugs

Question 1

Adverse drug reactions are 2 to 3 times greater in older adults and account for what percentage of their hospital admissions?

Answer 1

10-35 Percent.

Question 2

A list used as a guide to assist healthcare providers improve medication safety for Older adults and inform clinical decisions making concerning the quality of care.

Answer 2

AGS BEERS

Question 3

Refers to what a body does to the drug. It is the impact of absorption, distribution, metabolism, and in elimination of drugs.

Answer 3

Pharmacokinetics

Question 4

Drug distribution is affected by three things. Name them.

Answer 4

1. Body water
2. Body fat
3. Lean body mass

Question 5

As human beings age they have less Body water and intracellular water. What can these changes lead to?

Answer 5

Increased concentrations of water soluble drugs.

Question 6

As people age their added body fat may do what to their drug distribution?

Answer 6

Added body fat may increase the distribution of fat soluble drugs such as benzodiazepines causing prolonged half-lives and accumulation of the drug in the fat stores of the body.

Question 7

Decreased lean body mass can cause what in drug distribution?

Answer 7

Causes an increase in Serum concentration of protein bound drugs such as warfarin or Lanoxin. Nurses should pay particular attention to protein found drug use in malnourished older patients.

Question 8

The amount of the drug that reaches systemic circulation is known as?

Answer 8

Bioavailability. This also affects drug distribution and may be altered by the route of administration, drug solubility, and general circulation to the site where the drug is given.

Question 9

Changing drugs to more active forms occur in all tissues of the body but the main site is in the liver. Through this the liver detoxifies drugs and prepares them for excretion.

Answer 9

Biotransformation

Question 10

The process of biotransformation takes place through complex enzyme activity that occurs in the?

Answer 10

Cytochrome p450 system.

Question 11

Concomitant Diseases, gender, genetics, nutrition, activity levels, and caffeine, tobacco and alcohol ingestion all affect what?

Answer 11

Metabolism of drugs

Question 12

The liver metabolizes drugs in one of two ways. Name the two ways.

Answer 12

Phase 1) Oxidation or reduction.

Phase 2) Conjugation

Question 13

Refers to when a drug is metabolized by the liver into more polar compounds.

Answer 13

Phase 1) Oxidation or reduction.

Question 14

Liver metabolism of a drug to a more water soluble molecule.

Answer 14

Phase 2) conjugation.

Question 15

Refers to the specific action of a drug at the tissue level.

Answer 15

Pharmacodynamics

Question 16

The most significant change with relation to drug use and effects in older adults is the age related changes to what?

Answer 16

Kidneys

Question 17

Beginning between the ages of? & ?, The glomerular filtration rate begins to fall approximately 1% per year based on age alone.

Answer 17

35-40 years.

Question 18

Older adults who have the following conditions are as specially at risk when given medications that are excreted renally such as digoxin, and vancomycin and imipenem.

Answer 18

Hypertension
Diabetes
Chronic medical conditions

Question 19

Is an indirect measure of glomular filtration rate.

Answer 19

Creatinine clearance

Question 20

True or false, an older adult that has a normal serum creatinine will have a normal creatinine clearance.

Answer 20

False

Question 21

Polypharmacy can be defined as?

Answer 21

Taking more than six medications on a daily basis. Taking multiple medications that interact with one another. Taking medications to counteract the side effects of other medications.

Question 22

Adverse drug reactions cause what percentage of all hospitalizations in older adults?

Answer 22

28%

Question 23

In patients who are on multiple medications that develop a new symptom, the nurse should consider what?

Answer 23

That it could be an adverse drug reaction.

Question 24

What is the guiding principle for prescribing medication for the older person?

Answer 24

Start low and go slow.

Question 25

This herbal remedy can cause photosensitivity and possible serotonin syndrome if used with an SSRI.

Answer 25

St. John’s wort.