Pharm in Older Adults Flashcards
What can affect absorption of many fluoroquinolones–Ciprofloxacin?
Divalent cations–Ca, Mg, Iron
What occurs if an individual has a decrease in body water with respect to volume of distribution of a drug?
Lower VD for hydrophilic drugs
What occurs if an ind. has a decrease in lean body mass with respect to volume of distribution of a drug?
Lower VD for drugs that bind to muscle
What occurs if an ind. has an increase in fat stores with respect to volume of distribution of a drug?
Higher VD for lipophilic drugs
What occurs if an ind. has a decreased plasma protein (albumin) with respect to volume of distribution of a drug?
Higher % of drug that is unbound
Why are drugs that use the phase 2 pathway favored in older inds. when compared to phase 1?
Phase 2 pathways convert drugs to inactive metabolites that do NOT accumulate
Phase 1 pathways–hydroxylation, oxidation, dealkylation and reduction–> convert drugs to metabolites with greater, lesser, or the same effect as the parent compound
Why are benzodiazepines avoided with older inds?
May cause more sedation and poorer psychomotor performance in older adults–likely caused by reduced clearance of the drug and resultant higher plasma level
Older pts may experience higher levels of morphine with longer pain relief
What medication can become toxic in older pts even with normal serum levels?
Digoxin
What medication is associated with lots of falls and hip fractures seen in older pts?
Diphenhydramine
What are the risks involved with ACE inhibitors + diuretics?
Hypotension and Hyperkalemia
What is the risk involved with ACE inhibitors +K?
Hyperkalemia
What are the risks involved with Antiarrhythmic + diuretic?
Electrolyte imbalance and arrhythmias
What are the risks involved with Benzos + antidepressant, antipsychotic, or benzo?
Confusion
Sedation
Falls
What is the risks involved in Ca channel blocker + diuretic or nitrate?
Hypotension
What are the risks involved in Digitalis + anti arrhythmic?
Bradycardia
Arrhythmia
