Module 5 Flashcards
__% of community dwellers ages 57 to 85 take at least 1 prescription drug.m__% used 5 or more medications
81, 29
Older adults in the U.S. Take ___ % of all drugs
34
Nursing home residents use more than ___ prescription drugs per day
8
Older adults purchase more than __% of over the counter medications
40%
Prescription drugs sales in 2013 were _____ up ___% from 2012
326 billion, 2.3%
Medication use in elderly exceeds younger due to
Increased prevalence of disease, clinical practice guidelines, direct consumer marketing, inappropriate prescribe practices, and unmonitored self medication
Pharmokinetics is
How the body effects the drug after administration through absorption and distribution and chemical changes in the body
What is half life
Time it takes for one half life of original drug dose to be removed from the body
Half life may be reduced by ___% with age
50
What are the four components of pharmokinetics
Absorption, distribution, metabolism and excretion
What is the volume of distribution
The relative portion of a drug in the body as a function of body mass
What is drug clearance
A function of the volume of distribution, metabolism and excretion
Physicians use ________ to determine drug dosage required at each dosing level to achieve therapeutic effect
Drug clearance
What is absorption
The rate at which a drug leaves the administration site
What is bioavailability
An index measure of amount of drug that reaches systemic circulation
Manufacturers use __________ data to determine optimum drug dosage or strength that produces desired therapeutic effect
Bio availability
What is distribution
The extent of drug dispersion in systemic circulation to site of action
Most distribution occurs via _________
Passive diffusion
___ soluble drugs are more rapidly and extensively absorbed
Fat
Protein binding capacity diminishes ___% with age
25
Drug binding is decreased due to lower ____
Albumin levels
More part of the drug remains in circulation causing a higher _____ drug level
Free fraction
What is metabolism
A biological transformation of a drug into an inactive molecule, a soluble compound or a potent metabolite
Where does metabolism primarily occur
Liver
Most agents are metabolized by ______ enzymes
Cytochrome P450 enzymes
What is excretion
Elimination of drug from body
Which pharmokinetics parameter is most effected by aging
Excretion
What is the primary organ responsible for drug elimination
Kidney
What is pharmacodynamics
The relationship between drug concentration at a site of action and the resulting effect.
What happens to receptors with age
Decrease in number, decrease in drug affinity and decreased receptor competency
What is down regulation
Cellular decrease in number of receptors to molecule which reduces cell sensitivity to molecule
What is affinity
Tendency of a molecule to associate with another
What is prescription drug abuse
Use of medication without a prescription, in a way other than prescribed, or for experience or feelings elicited
What is underutilizTion
When physicians refrain from prescribing a drug with indications known to benefit from drug therapy
Reasons for underutilization
Lack of knowledge, lack of time, financial concerns, lack of quality research and fear of ADR
The beers criteria created in ____ was created to
1997, analyze and evaluate medication use to decrease the number of medication related problems
A screening tool for prescription drug use
Screening Tool of Older Persons Potentially inappropriate Prescriptions (STOPP)
What is poly pharmacy
Use of medication for which no clear indication exits or use of more than one medication from the same class
What is irrational poly pharmacy
Inappropriate drug Prescription
What is the most common kind of drug interaction
Drug to drug
What are adverse drug reactions
Noxious, unintended reactions that occur at doses used diagnosis, prophylaxis. Or treatment
Adverse drug reactions usually occur ___ days after initiation
4
What is adherence
The extent to which a persons behavior conforms with medical or health advice
What is non adherence
Number of doses not taken or taken incorrectly that jeopardizes the patients therapeutic outcome
NSAIDs should be taken __ to ___ minutes prior to therapy
60 to 90
Opioids should be take. __ to __ minutes before therapy
30 to 90
Topical and transdermal agents should be taken __ minutes prior to therapy
60 minutes
Beta blockers should be taken _ to _ hours before therapy
1 to 2
Calcium channel blockers should be taken _ to _ hours before therapy
2 to 6
Nutritional requires ___ with aging
Remain the same
Antioxidants may prevent against
Vision loss
Foods that help prevent Alzheimer’s
Vitamin E, omega 3 fatty acids, up hydrogenated unsaturated fats
What is gastroenteritis
Inflammation of lining of intestinal wall
What is gastritis
Malabsorption of protein and vitamin b complex
What is pernicious anemia caused by
Lack of vitamin B12
Calcium intake recommendations
1200-1500 mg per day
Vitamin D recommendations per day
600-800 IU
Two nutrition assessment tools
Subjective global assessment and mini nutritional assessment
Carbohydrate re commendations
45-65%, 35-40 kcal/kg/day
If someone has an infection, wound or catabolic stress add ____ carbs
25-30 kcal/kg/day
Protein recommendations
15% or .8-1 kcal/kg/day
Healthy active adults should have this much protein
1.25/kcal/kg/day
If there is infection, wound, catabolic stress add this much protein
1.2 -1.5 kcal/kg/day
Fat recommendations
20% no more than 35%
Saturated fat levels should be ___
Less than 10%
Cholesterol should be
Less than 300 mg
What should the ratio of magnesium to calcium be in supplements
1:2 or 1:3
Vitamin B12 is important for
Maintaining nerve tissue, nuclei can acid metabolism and for preventing megablastic anemia
What are the effects of lack of vitamin B12
Fatigue, anemia, muscle weakness, loss of appetite,weight loss, diarrhea, nausea, tachycardia, numbness and tingling in UE and LE
Recommended values of vitamin B12
2.4 ug/day
Vitamin c recommendations
400 mg/day
Vitamin c increase __ and ____
Fibroblast proliferation and collagen synthesis
Vitamin D promotes ____ and ___
Bone mineralization and bone formation and metabolism
Vitamin D deficiencies are associated with
Poor balance, cognitive effects, cancer, fractures, increased mortality from CVD
Zinc is necessary for
Protein digestion and synthesis
Zinc recommendations
8-11 mg
Folate recommendations
250-1000 mcg daily
Water recommendations
3.7 L /d for men and 2.7 L/ d for women
What is h hypertonic dehydration
When there is a greater loss of water rather than sodium loss
What is isotonic dehydration
Equal amounts, you see diarrhea and vomiting
What is hypotonic dehydration
Greater amount of sodium loss to water loss, found with use of diuretics
What is the administration on agings elderly nutrition program
Provides grants to support nutrition services to older adults by prodding home delivered meals that provide at least 1/3 or RDAs
