Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics P2 > Module 2 Exam 1 Lecture 1 > Flashcards

Module 2 Exam 1 Lecture 1 Flashcards

1
Q

A1c tx goal for geriatrics

A

7-8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a key assumption that is made when treating a patient with chronic medical condition

A

low life expectancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How long of a treatment of diabetes treatment is needed to avoid organ failure

A

10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do we treat diabetic patients for patients that have a chronic medical condition with low life expectancy

A

Control for hypoglycemia, while treating the polyuria and polydipsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why are sulfonylureas not 1st line for older adults

A

Due to risk of hypoglycemia, older adults are more likely to experience side effects
Also more likely to experience falls and CVD death relative to younger adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common geriatric syndromes

A

Sensory impairment (vison and hearing)
Incontinence
Constipation
Poor nutrition
depression
insomnia
Poverty
falls
Delirium
Dementia
Weakness
Immobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the two functional categories of abilities in older adults

A

ADLs and IADLs
(activity of daily living vs Instrumental activities for daily living)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some ADLs

A

Dressing
bathing
feeding
toileting
walking/ambulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some IADLs

A

Handling finances
shopping for groceries
meal preparations
using a telephone
house keeping/laundry
handling meds
using transportation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some medications that can cause a risk of falls

A

Sedative/hypnotics
Neuroleptics/antipsychotics
antidepressants
opioids
loop diuretics
alpha blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the beers criteria

A

Because of age, relative to a younger population, are you at a higher risk of adverse medical conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are 3 medication problems in older adults

A

Polypharmacy
Non-adherence
PK changes with aging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why can polypharmacy be a problem in older adults

A

Multiple medications without an indication
Medications treating ADRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Older patients are more adherent to meds than younger ones

A

TrueW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some physiologic changes that occur when we age that can affect the PK of drugs

A

Decrease in TBW
Decrease in lean body mass
Increase in body fat
Decrease in baroreceptor response activity (sitting down for 8 hours and standing up dizzy)
decrease in HR variability
Decrease in hepatic blood and renal blood flow
decreased neurotransmitter volume (Increased sensitivity to CNS adverse effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens to tmax in older adults

A

Slows down

17
Q

What happens Vd and concentration of water soluble drugs in older patients

A

decrease in volume of distribution and increase in concentration of drug due to the decrease in total body water. (atenolol)

18
Q

What happens to Vd and t1/2 of lipid soluble drugs in older patients

A

Increased Vd and increased t1/2 of lipid soluble drugs (rifampin)

19
Q

what happens to clearence and t1/2 of hepatically cleared drugs in older patients

A

Decreased clearence and increased t1/2 of most hepatically cleared drugs (propanolol)

20
Q

What happens to clearence and t1/2 of most renally cleared drugs

A

decreased clearence, increased t1/2 of most renally cleared drugs

21
Q

beers criteria is for adults aged above

A

65 and up

22
Q

Which type of medications should we evaluate risks for in older adults

A

Meds with anticholinergic properties
Sedatives with CNS effects
Diabetic agents

23
Q

What should we focus on when assesing risk of anticholinergic agents in older adults

A

Focus on risk of cognitive impairment

24
Q

What should we focus on when assessing risk of diabetic drugs in older adults

A

Sliding scale insulin, long acting sulfonylureas

25
Q

Beers criteria diabetes drugs

A

Sulfonylureas (glipizide, glyburide, glimepride)
SGLT2s (flozins)Sliding scale insulin)

26
Q

What is a big recommendation for rational prescribing

A

recognize new symptoms as potential adverse rxns

27
Q

considerations in choosing medications

A

Remaining life expectancy
time to benefit
Goal of care
Tx targets

28
Q

What is palliative care

A

after diagnosis of terminal illness, disease not responsive to curative tx or tx does not exist

29
Q

What are some goals for palliative care

A

Optimize QOL and focus on sx only not on prolonging life
stop meds not improving QOL

30
Q

What is hospice care

A

provides at home facility. Life expectancy is 6 months or less

31
Q

Does beers criteria apply to palliative or hospice care?

A

no

32
Q

What does ACD stand for

A

advanced care directives

33
Q

what is an ACD

A

Verbal and written instructions about future medical care and tx (allows you to make a choice of if I am in a life threatining situation, do I want chest compressions, intubated? ETC…)

34
Q

ACDs include

A

healthcare representatives- names someone to make decisions in patient is not able

psychiatric advanced directives- sets preferences during periods of incapacity

power of attorney- financial or healthcare power to other people you choose

35
Q
A

Therapeutics P2 (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions