Pharmacology Flashcards
Polypharmacy
Administration of many drugs together
Administration of excessive medication
Excessive or inappropriate use of medications
Changes in Absorption and distribution
absorption- altered G.I. function
distribution -changes in total body water, lean body mass percent body fat plasma, protein concentrations
Changes in metabolism and excretion
metabolism-reduced liver mass, decreased hepatic, blood flow, decreased activity of drug metabolizing enzymes
Excretion- decreased renal blood flow in mass decreased function of renal tubules
pharmacokinetic changes results in
Drugs and drug metabolites remain active for longer periods of time and prolonging drug effects, thereby increasing risk for toxic side effects
physiological systemic changes
Homeo static control of circulation
Impaired postural control
Decrease visceral muscle function
Changes in thermal regulation
Declining cognitive ability
Cellular level changes
Binding receptor changes
Increased or decreased sensitivity
Common ADR’s
G.I. symptoms
Sedation
Confusion
Depression
orthostatic hypotension
Fatigue/ weakness
Dizziness/falls
anticholinergic effects
Extra pyramidal symptoms
G.I. symptoms
nausea, vomiting, diarrhea, constipation
Common with opioids, non-opioids and NSAIDs
sedation
Common with opioids analgesics antipsychotics
Sometimes excessive sedation seen with sedative hypnotics
Confusion
Common with antidepressants narcotic analgesic, drugs with anticholinergic activity
depression
Common with barbiturates antipsychotics alcohol, some anti-hypertensive drugs
Orthostatic hypotension
Most common with drugs used to treat hypertension
fatigue weakness
Common with skeletal muscle, relaxants, and diuretics
Altered electrolyte balance
dizziness falls
Common with sedatives antipsychotics opioid analgesic antihistamines
Anticholinergic effects
alters response of tissues to acetylcholine
common With antihistamines antidepressants and antipsychotics
CNS- confusion, nervousness, drowsiness, dizziness
Peripheral - dry mouth, constipation urinary retention tachycardia, blurred vision
extra pyramidal symptoms
Dystonias, tardive dyskinesia, pseudo Parkinsonisms
Common with antipsychotics
Cardinal features of immune system aging
Weakened antimicrobial immunity
Impaired anti-vaccine responses
Insufficient protection against malignancies
Predisposition for unopposed tissue inflammation
failing wound repair mechanism
increased systemic inflammation due to immune system changes includes
Increased inflammatory cytokines
Increased C reactive protein
Increased tumor necrosis factor
immune system changes may occur because of
Shift and fat mass from periphery to abdomen along with general increase in overall intra-abdominal fat with age
Abdominal fat metabolically active and serves as inflammatory organ
Increase inflammatory cytokines associates with metabolic syndrome and decrease organ system function
Systemic inflammation changes can result in
muscle wasting
Loss of physical function
Underlying factor and development of age related diseases like Alzheimer’s atherosclerosis, cancer diabetes
reduction in lymphocyte development
decreased T and B cell development
Decreased quality and composition of lymphocyte pool
Decreased thymic cells
This results in decreased efficiency of response to novel or previously encountered antigens
Decrease responsiveness to vaccines
approaches to address total body inflammation
Anti-inflammatory drugs
Antioxidants
Caloric restriction
Exercise
therapy implications of exercise
decrease inflammatory markers
Resist fatal infection and aggressive pathogens
Wider window of homeostasis
Enhances systemic reserve
Decreases risk for disease
Delays functional decline
with increased physical activity
Reduced risk of chronic age related diseases
Reduced risk of all cause mortality
Lower cardio metabolic risk factors
Improve muscle mass and function
lower Systemic inflammation
Improved vaccine responses
First sign of illness
change in mental status
Decline in function
falls
Weight loss
Slight increase in respiratory rate
Symptoms such as nausea, vomiting, decreased urinary ouput
most common type of infectious disease
Bacterial pneumonia
Urinary tract infections UTI
atypical presentation of conditions
Heart failure
Acute bowel obstruction
biliary Or liver disorders
look for Cognitive dysfunction or confusion
