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Primary Care EXAM 1 > Pharm - Geriatrics > Flashcards

Pharm - Geriatrics Flashcards

1
Q

Given the change in pH with age, what do you expect to happen if an elderly patient takes an antifungal?

A
  • antifungals require acidity for digestion but pH increases with age so efficacy will be decreased
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2
Q

How might the change in ratio between adipose and lean tissue in the elderly change the efficacy of antipsychotics?

A

the greater increase in adipose tissue will increase the efficacy of antipsychotics because they are lipophilic

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3
Q

How might the change in ratio between adipose and lean tissue in the elderly increase the risk of aminoglycoside related side effects?

A
  • less lean tissue decreases the amount of water
  • aminoglycosides are hydrophilic
  • net effect = greater concentration in lower volume = more side effects
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4
Q

In general what is the trend in albumin vs. alpha 1 glycoprotein with aging?

A
  • albumin decreases

- alpha 1 glycoprotein increases

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5
Q

What cytochrome family of enzymes are not only located in the liver but in the intestinal tract as well?

A

CYP450 3A 4/5 enzymes

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6
Q

Given the decrease in phase 1 reactions seen with aging how might this effect an active drug vs a pro drug?

A
  • more active drug will reach systemic circulation

- less active drug will be made from pro drug

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7
Q

The recommended dose of this drug is specifically defined by the age of the patient.

A
  • Ambien (Zolpidem)
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8
Q

What is the primary reason benzodiazepines are prescribed for the elderly?

A

insomnia

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9
Q

What is the primary reason benzodiazepines are prescribed for the younger population?

A

anxiety

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10
Q

What is the trend in benzo prescription with age in the U.S.?

A
  • increases with age
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11
Q

Abrupt cessation of benzodiazepines leads to what?

A
  • rebound insomnia
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12
Q

What are the 2 adverse effects you are concerned for in the elderly population who take benzos?

A
  • increased risk of falls

- impair cognition

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13
Q

What other drug class has the same adverse effects as benzos in the elderly?

A
  • opioids
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14
Q

What tends to happen with age to nephrons in the kidney?

A
  • nephrons decrease with age
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15
Q

What is the most accurate measurement of estimated kidney function?

A
  • 24 hr urine collection
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16
Q

Why is a low creatinine level in the elderly misleading?

A
  • creatinine is a breakdown product of muscle and most elderly patients have low muscle mass
  • round up to 1
17
Q

FQs increase the risk of tendinitis and tendon rupture in what population?

A
  • those over the age of 60
  • who are transplant recipients
  • and are on steroids
18
Q

What are the 2 most prevalent predictors of creatinine clearance?

A
  • genes

- other drugs

19
Q

What is the major drug class that accounts for the majority of ED visits in patients over 65 years old?

A
  • antithrombotics
20
Q

What is the major drug class that accounts for the majority of ED visits in the adolescent populations?

A
  • antibiotics
21
Q

Why is there a drug-drug interaction between macrolides and non-DHP CCBs?

A
  • macrolides are CYP inhibitors so more CCB is available is bioavailable
22
Q

NSAIDs may lead to what adverse effect that then requires treatment with another drug?

A
  • HTN
23
Q

DHB CBBs may lead to what adverse effect that then requires treatment with another drug?

A
  • peripheral edema
24
Q

HCTZ may lead to what 2 adverse effects that then requires treatment with another drug?

A
  • changes in K+

- impaired clearance of uric acid

25
Q

Pseudoephedrine may lead to what 4 adverse effects that then requires treatment with another drug?

A
  • increase BP
  • insomnia
  • rebound congestion
  • urinary retention
26
Q

Metoclopramide may lead to what adverse effect that then requires treatment with another drug?

A
  • parkinson like symptoms
27
Q

Any patient with HF should avoid or minimize this drug class due to its effect on the kidneys.

A
  • NSAIDs
28
Q

What is the mechanism of action of Donepezil (Aricept) for treatment of dementia?

A
  • inhibits the enzyme acetylcholinesterase which increases Ach
29
Q

What is the second line treatment for dementia if cholinesterase inhibitors does not work?

A
  • NMDA antagonists (Memantine [Namenda])
30
Q

What is the preferred anxiolytic in the elderly?

A
  • buspirone
31
Q

Why is adherence important with DOACs?

A
  • they are short acting drugs so you can’t miss a dose
32
Q

Most patients will not tolerate cholinesterase inhibitors d/t this side effect.

A
  • nausea

Primary Care EXAM 1 (7 decks)

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