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Older Adults - Midterm > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

percentage of older adults w/ one or more chronic conditions

A

80%

drug therapy is primary method of tx

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2
Q

consumption of prescribed and non prescription meds

A

65 yrs and older

prescribed = 31%

nonprescription = 40%

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3
Q

what dictates polypharmacy

A

multiplicity of dz

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4
Q

% of older adults that use five or more meds

A

50

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5
Q

% of older adults that use ten or more meds

A

12

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6
Q

institutionalized population is given …

A

5-8 prescriptions meds compared to community dwellers

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7
Q

how does aging affect a drug

A

absorption

excretion

distribution

metabolism

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8
Q

what is absorption

A

process by which the drug passes from the GI tract into the bloodstream

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9
Q

how does absorption occur in older adults

A

complete in elderly

but occurs at a slower rate

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10
Q

age related changes affecting absorption

A

decreased…

-gastric secretions and acidity
-GI surface area
-gastric emptying
-intestinal motility

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11
Q

clinical implications –> absorption

A

decrease absorption rate

increased time for peak effect

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12
Q

what does distribution determine

A

concentration of the drug

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13
Q

what do drugs have an affinity for

A

certain body component

affecting their action at the target site

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14
Q

what does decrease in distribution make the elderly more susceptible to

A

drug toxicity and side effects

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15
Q

age related changes influencing distribution…increasing

A

peripheral resistance

fat mass

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16
Q

age related changes influencing distribution…decreasing

A

cardiac output

body water content

lean body mass

serum albumin

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17
Q

clinical implication –> distribution

A

decreased volume of distribution of drug

change in response to drug

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18
Q

metabolism is also called

A

biotransformation

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19
Q

metabolism

A

inactivation of the drugs

creates water soluble metabolites that can be excreted by the kidneys

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20
Q

what does metabolism determine

A

length of time the drug is in the body

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21
Q

age related changes affecting metabolism

A

reduction of hepatic blood flow

decreased liver sized

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22
Q

reduction of hepatic blood floor –> metabolism

A

drugs are metabolized more slowly in the elderly

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23
Q

clinical implication –> metabolism

A

drugs that undergo inactivation in the liver –> remain active for longer time

leading to hepatotoxicity

24
Q

excretion

A

process of elimination of the drug from the body

25
Q

where are drugs majorly excreted

A

kidneys

26
Q

what do age related changes to the kidneys

A

overall decrease in excretion

decrease in the accumulation of drugs and drug metabolites within the body

27
Q

age related changes affecting metabolism

A

decline in

-renal blood flow
-renal mass
-renal tube fxn

28
Q

clinical implications related to metabolism

A

prolong drug effects

increase toxic effects on kidneys

drug half life is longer in older adults

29
Q

half life

A

time it takes for the body to remove half of the drug

out of the entire body

30
Q

common meds used by older adults (1)

A

antihypertensive

ace - inhibitors

beta - blockers

nitrates

31
Q

common meds used by older adults (2)

A

statins

anticoagulants and antiplatelets

diabetic meds

glucocorticoids

anti-dementia

32
Q

antihypertensive meds

A

decrease BP and rate if increase if stunted

33
Q

what do hypertensive meds caused

A

dysrhythmia

dehydration

34
Q

ace inhibitors side effects

A

hypotension

35
Q

beta-blockers medications end in

A

-lol

36
Q

beta blockers SEs

A

blunted exercise response

37
Q

what do you use with pts that are on beta blockers

A

RPE during exercise

not HR!!!

38
Q

why dont we use HR with beta blockers

A

meds change the beat of the heart

39
Q

what do nitrates do

A

increase peripheral vasculature

decrease cardiac workload

decrease oxygen demand

40
Q

nitrates SE

A

hypotension

dizziness

41
Q

what do pts with nitrates experience after exercise

A

vasodilating effects

“ok” BP

BP falls after exercise

42
Q

what do statins do

A

improve lipid profile

43
Q

SE of statins

A

statin induced myopathy

weakness

44
Q

anticoagulants and antiplatelets prevent

A

prevent platelet aggregation

45
Q

SE of anticoagulants and antiplatelets

A

bleeding

bruising

HA

46
Q

diabetic meds ex

A

metaformin

47
Q

where do pts inject insulin

A

away from exercising muscles

48
Q

what should we always have around when working with pts w/ diabetes

A

carbs

(15 g)

49
Q

glucocorticoids

A

anti-inflammatory

50
Q

SE of glucocorticoids

A

steroid myopathy

tendon rupture

osteoporosis

51
Q

anti-dementia SE

A

diarrhea

depression

weight loss

mm cramps

52
Q

polypharmacy

A

excessive prescription and self administration of meds

53
Q

how does polypharmacy occur

A

multiple providers may be unaware of new prescriptions or med changes

esp after hospitalization

54
Q

what plays a role in the absorption of drugs

A

smoking/alcohol

55
Q

adverse drug reaction (ADR)

A

noxious, unintended reactions that occur at doses normally used for dx, prophylaxis or tx

56
Q

how does polypharmacy relate to PT

A

need to know the beneficial and adverse effects of each meds and how they can affect the rehab of our pts

57
Q

what could we do as PTs

A

recognize ADRs

encourage proper adherence to drug therapy

discourage improper use of unnecessary meds

Older Adults - Midterm (4 decks)

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