Pharmacology Flashcards
acidic drugs require a ___ environment for absorption
acidic
basic drugs require a ___ environment for absorption
basic
examples of acidic drugs
aspirin, phenytoin, penicillins
examples of basic drug
morphine, diazepam, pethidine
possible issues in drug absorption on route of delivery?
dysphagia - liquid/syrup
can tablets be crushed for PEG/NG tube
confused patients not taking medicine
NBM patients
what protein binds acidic drugs
albumin
what protein binds basic drugs
alpha-1 acid glycoprotein
why are basic drugs carried by protein binding better in older patients
lower albumin and higher alpha-1 acid glycoprotein
why do older patients have a higher volume of distribution for lipophilic drugs
higher proportion of body fat compared to muscle mass
what is drug half life
time taken for drug to fall to have of its max concn
what happens to half life in kidney/liver dysfunction
increase
describe why lipophilic drugs have a longer half life
they have a higher volume of distribution so higher half life
why is decreased body water an important change in older people and how may this lead to adverse effects on named drugs
digoxin or Li
lowers volume of distribution so therefore can lead to more toxic side effects
drugs that you should monitor levels
theophylline warfarin lithium digoxin levothyroxine gentamicin phenytoin cyclosporin carbamazepine vancomycin
true/false - drug therapeutic windows narrow woth age
true
true/false - calcium affects levothyroxine absorption
true
common drug side effects on older patients
cognition and consciousness bowel function and constipation dizzy or off balance drug interactions anticholinergic
symptoms of anticholinergic side effects
dry mouth constipartion urine retention tachycardia blurred vision confusion or hallucination long term risk dementia
in addition to anticholinergics, what other drugs can cause anticholinergic side effects
antidepressants antiemitics opiates anti-parkinsonian antipsychotics antihistamines BZD beta blockers
what is the anticholinergic burden
multiple classes of drugs lead to anticholinergic side effects, that wouldnt normally on their own
true/false - gabapentin should be stopped in elderly for low back pain
true - no evidence of benefit but evidence of risk
true/false - paracetamol is better than a placebo for OA pain
false
