Pharmacology

Question 1

What are the definitions of Polypharmacy?

Answer 1

• Administration of many drugs together
• Administration of excessive medication
• Excessive or inappropriate use of medications

Question 2

What are some factors that contribute to the reason that older adults consume more drugs as compared to their younger counterparts?

Answer 2

• more illness
• more adverse drug reactions (ADRs)
• Physician reliance on drug therapy over non-pharmacologic options
• multiple prescriptions from multiple providers
• over the counter and self help remedies
• sharing medications

Question 3

What is the polypharmacy cycle?

Answer 3

1. more illness in older adults
2. need/take more drugs
3. increased risk of side effects
4. side effects seen as symptoms
5. more drugs administered
   repeat

Question 4

What are common characteristics of Polypharmacy?

Answer 4

• Use of medications for no apparent reason
• use of duplicate medications
• concurrent use of interacting medications
• use of contraindicated meds
• Use of inappropriate dosage of medications
• Use of drug therapy to treat ADRs
• Patient improves with discontinuation of medications

Question 5

What are pharmacokinetic changes?

Answer 5

How the body handles certain drugs

Question 6

What is the result of major pharmacokinetic changes?

Answer 6

drugs and drug metabolites remaining active for longer periods of time and prolonging drug effects thereby increasing risk for toxic side effects

Question 7

What 4 things are altered the most with pharmacokinetic changes?

Answer 7

Absorption-altered GI function
Distribution- changes in total body water, LBM, % body fat, and plasma concentrations
Metabolism-reduced liver mass, decreased hepatic blood flow, decreased activity of drug metabolizing enzymes
Excretion- decreased renal blood flow and mass, decreased function of renal tubules

Question 8

What are Pharmacodynamic changes?

Answer 8

How drugs affect the body

Question 9

What are some physiologic systemic changes can occur with pharmacodynamic changes?

Answer 9

• Homeostatic control of circulation-impacts cardiovascular drugs
• Impaired postural control
• decreased visceral muscle function
• changes in thermoregulation
• declining cognitive ability

Question 10

What are cellular level changes and biochemical response changes with pharmacodynamic changes?

Answer 10

(cellular) -Binding receptor changes-increased or decreased functional changes
(biochemical) -Subcellular structural and functional changes

Question 11

What are common ADRs that effect the GI system? What types of medications are associated with these symptoms?

Answer 11

nausea, vomiting, diarrhea, constipation

Opioids, non-opioids, and NSAIDS

Question 12

What types of medications are associated with sedative symptoms or ADRs?

Answer 12

opioids, analgesics, antipschotics and sedative-hypnotics

Question 13

What types of medications are associated with confusion symptoms or ADRs?

Answer 13

antidepressants, narcotic analgesics, and drugs with antocholinergic activity

Question 14

What types of medications are associated with depression symptoms or ADRs?

Answer 14

barbiturates, antipsychotics, alcohol, and some antihypertensive drugs

Question 15

What types of medications are associated with developing Orthostatic hypotension?

Answer 15

drugs used to treat hypertension

Question 16

What types of medications are associated with symptoms such as fatigue or weakness?

Answer 16

muscle relaxants and diuretics (drugs that alter electrolyte balance)

Question 17

What types of medications are associated with symptoms such as dizziness or falls?

Answer 17

sedatives, antipsychotics, opioid analgesics, and antihistamines

Question 18

What is the definition of antocholinergic effects? What drugs commonly cause these effects as side effects? What are some symptoms?

Answer 18

alters response of tissues to acetylcholine

common drugs- antihistamines, antidepressants, and antipsychotics

CNS symptoms-confusion, nervousness, drowsiness, dizziness
Peripheral Symptoms- dry mouth, constipation, urinary retention, tachycardia, blurred vision

Question 19

What are common extrapyramidal symptoms and what drugs cause them?

Answer 19

dystonias, tardive diskinesia, and pseudoparkinsonisms

common with antipsychotics