Pharmacology

Question 1

acidic drugs require a ___ environment for absorption

Answer 1

acidic

Question 2

basic drugs require a ___ environment for absorption

Answer 2

basic

Question 3

examples of acidic drugs

Answer 3

aspirin, phenytoin, penicillins

Question 4

examples of basic drug

Answer 4

morphine, diazepam, pethidine

Question 5

possible issues in drug absorption on route of delivery?

Answer 5

dysphagia - liquid/syrup
can tablets be crushed for PEG/NG tube
confused patients not taking medicine
NBM patients

Question 6

what protein binds acidic drugs

Answer 6

albumin

Question 7

what protein binds basic drugs

Answer 7

alpha-1 acid glycoprotein

Question 8

why are basic drugs carried by protein binding better in older patients

Answer 8

lower albumin and higher alpha-1 acid glycoprotein

Question 9

why do older patients have a higher volume of distribution for lipophilic drugs

Answer 9

higher proportion of body fat compared to muscle mass

Question 10

what is drug half life

Answer 10

time taken for drug to fall to have of its max concn

Question 11

what happens to half life in kidney/liver dysfunction

Answer 11

increase

Question 12

describe why lipophilic drugs have a longer half life

Answer 12

they have a higher volume of distribution so higher half life

Question 13

why is decreased body water an important change in older people and how may this lead to adverse effects on named drugs

Answer 13

digoxin or Li

lowers volume of distribution so therefore can lead to more toxic side effects

Question 14

drugs that you should monitor levels

Answer 14

theophylline 
warfarin 
lithium 
digoxin 
levothyroxine 
gentamicin 
phenytoin
cyclosporin 
carbamazepine 
vancomycin

Question 15

true/false - drug therapeutic windows narrow woth age

Answer 15

true

Question 16

true/false - calcium affects levothyroxine absorption

Answer 16

true

Question 17

common drug side effects on older patients

Answer 17

cognition and consciousness
bowel function and constipation 
dizzy or off balance 
drug interactions 
anticholinergic

Question 18

symptoms of anticholinergic side effects

Answer 18

dry mouth 
constipartion 
urine retention 
tachycardia 
blurred vision 
confusion or hallucination 
long term risk dementia

Question 19

in addition to anticholinergics, what other drugs can cause anticholinergic side effects

Answer 19

antidepressants 
antiemitics 
opiates 
anti-parkinsonian 
antipsychotics 
antihistamines 
BZD 
beta blockers

Question 20

what is the anticholinergic burden

Answer 20

multiple classes of drugs lead to anticholinergic side effects, that wouldnt normally on their own

Question 21

true/false - gabapentin should be stopped in elderly for low back pain

Answer 21

true - no evidence of benefit but evidence of risk

Question 22

true/false - paracetamol is better than a placebo for OA pain

Answer 22

false