Pharmacology - Elderly Pharmacology - Sharon Brangman Flashcards
T/F: The bioavailability of a drug does not change as we get older.
True
Lower body water means what for drug distribution in the elderly?
Lower Vd for hydrophilic drugs
Higher fat stores mean what for drug distribution in the elderly?
Higher Vd for lipophilic drugs
Metabolic clearance of a drug by the liver may be reduced in the elderly because
aging decreases liver blood flow, size, and mass
Drugs from what phase are preferred for use in the elderly?
Phase II
Hepatic congestion from heart failure reduced the metabolism of what drug?
Warfarin
Smoking increases the clearance of what drug?
Theophylline
oxazepam is metabolized faster in older:
Men than older women
nefazodone concentrations are 50% higher in older:
women than younger women
In older adults, creatinine stays in the normal range, masking changes in what?
Creatinine clearance
Why do Benzodiazepines cause more sedation and poorer psychomotor performance in older adults?
Likely caused by reduced clearance of the drug and resultant higher plasma level
Confusion in the elderly should be considered what before dementia?
Drug interactions
What kinds of drugs are most responsible for causing ADEs in the elederly?
Cardiovascular drugs;
Psychotropics
What are the most common adverse effects of drug-drug interactions in the elderly?
Confusion
Cognitive impairment
Arterial hypotension
Acute renal failure
An ACEi and a diuretic together can cause what ADE?
Hypotension
Hyperkalemia
An ACEi and potassium together can cause what ADE?
Hyperkalemia
An antiarryythmic and a diuretic together can cause what ADE?
Electrolyte imbalance;
Arrhythmia
A benzodiazepine, an antidepressant, antipsychotic together can cause what ADE?
Confusion
Sedation
Falls
A calcium channel blocker and a diuretic or nitrate together can cause what ADE?
Hypotension
Digitalis and an antiarrhythmic together can cause what ADE?
Bradycardia
Arrhythmia
What are the best drugs to avoid in the elderly according to the Beers Criteria?
Benzodiazepines Megestrol Metclopramide Non-cox NSAIDs Nitrofurantoin Antipsychotics Insulin, sliding scale Chloropropamide Glyburide
