Nonprescription considerations for older adults

Question 1

What are some issues in older adults that can cause serious drug reactions?

Answer 1

1. altered PK and PD
2. Impaired kidney function
   3.Decreased liver blood flow
   4.Decreased liver size
   5.Increased body fat
   6.Decreased lean body mass
   7.Changes in receptor sensitivity
   8.Concomitant medical conditions

Question 2

What percentages of older adults are unable to identify maximum daily OTC doses and are not aware of when they shouldn’t use OTC?

Answer 2

Almost 1/3rd of older adults can not identify MDD

Question 3

What are the 4 types of drug misuse?

Answer 3

1.)Drug-age misuse
2.)Drug-drug misuse
3.)Drug-disease misuse
4.)Drug-label misuse

Question 4

How are OTC consultations associated with pharmacist job satisfaction?

Answer 4

Pharmacists consider OTC consultations to be a large part of their job. Positive association between job satisfaction and OTC medication consultation

Question 5

What percentage of older adults is at risk for OTC misuse?

Answer 5

95% are at risk of misusing OTC due to factors such as poor vision, low health literacy, and taking multiple prescription medications

Question 6

What is the percentage of adults older than 65 with low health literacy?

Answer 6

59% and 20% of primary care patients aged 55-74 lack skills needed to manage medications

Question 7

Why are anticholinergics on the BEERs criteria list?

Answer 7

Decreased clearance from the body as you get older
Can cause constipation, dry mouth, BPH, glaucoma, decreased mental cognition

Question 8

What do H2-receptor antagonists do(famotidine)?

Answer 8

Worsen mental status

Question 9

Why is mineral oil(oral) on BEERs list

Answer 9

It can get aspirated into the lungs and can cause pneumonia

Question 10

Non-COX-selective NSAIDs and older adults?

Answer 10

Increased risk of gastric ulcers
Compromised kidneys cause decrease clearance from body

Question 11

PPI and older adults

Answer 11

Higher rate of C.dif infections
Decreased bone density
Increased incidence of gastrointestinal malignancies

Question 12

Why was pseudoephedrine taken of the BEERs list in 2015?

Answer 12

Effects are not unique to older adults and can happen to everyone

Question 13

What OTC is of concern with heart failure

Answer 13

NSAIDs

Question 14

What OTC is of concern with delirium, dementia, cognitive impairment?

Answer 14

1st generation antihistamines, H2 receptor antagonists

Question 15

What OTC is a concern for falls and fractures

Answer 15

PPI

Question 16

What is a concern with kidney dysfunction

Answer 16

NSAIDs

Question 17

What is a concern with lower urinary tract symptoms and BPH

Answer 17

1st gen antihistamines and oral decongestants