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Y3 AGEING > Pharmacy > Flashcards

Pharmacy Flashcards

1
Q

Acidic drugs require an acidic environment to be absorbed, and basic drugs require a basic environment to be absorbed. True/False?

A

True

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2
Q

Give 3 examples of acidic drugs

A

Penicillin
Aspirin
Phenytoin

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3
Q

Give 3 examples of basic drugs

A

Diazepam
Morphine
Pethidine

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4
Q

What will the absorption of penicillin be like if you take a PPI at the same time?

A

PPI remove HCl from stomach, so less acidic environment, so penicillin won’t absorb as well

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5
Q

Which basic carrier protein binds acidic drugs?

A

Albumin

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6
Q

Which acidic carrier protein binds basic drugs?

A

Alpha-1 acid glycoprotein (A1AG)

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7
Q

In the elderly, which carrier protein is higher in abundance - albumin or A1AG?

A

A1AG (bind better to basic drugs)

Relative low albumin concn

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8
Q

Vd is a theoretical volume describing if all drug was absorbed into blood. The bigger the Vd, the more/less lipid soluble it is.

A

Vd is a theoretical volume describing if all drug was absorbed into plasma/blood. The bigger the Vd, the more lipid soluble it is.

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9
Q

What effect does a large Vd have on half-life of a drug?

A

Half-life of drug increases (big Vd means drug is sitting in adipose tissue)

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10
Q

Give the equation for calculating the therapeutic index of a drug

A

LD50/ED50

lethal dose50)/(effective dose50

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11
Q

List some drugs that have a narrow therapeutic index

A 
Warfarin
Theophylline
Levothyroxine
Digoxin
Lithium
Vancomycin
Gentamicin
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12
Q

What is a common side effect in elderly people being on PPIs? What is an alternative?

A

Hypomagnesia, hypokalaemia, hyponatraemia

Ranitidine

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13
Q

What side effects of oral NSAIDs must you consider when prescribing to an elderly person? What is the alternative?

A

Gastritis and ulcers
Fluid retention
Reduce effect of diuretics and antihypertensives
Topical NSAIDs, paracetamol

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14
Q

What must you consider when assessing an elderly patient on vasodilating antihypertensives? What are examples of these.

A

Reduction in BP

ACEi, CaCB

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15
Q

Elderly people on broad-spectrum antibiotics have an increased risk of C.diff compared to the average person. True/ False? What are these antibiotics?

A

True

4 Cs: co-amoxiclav, cephalosporins, clindamycin, ciprofloxacin

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16
Q

What are some side effects of elderly patients on bendroflumethiazide?

A 
Hypoperfusion
Biochemical imbalance (hypokalaemia, hyponatraemia)
17
Q

What type of drug has a high Vd and what type has a low Vd?

A 
High = lipophillic (lots of drug in fat)
Low = hydrophillic (lots in plasma)
18
Q

What is the equation for t1/2?

A

0.693 x Vd/ Cl (r+h)

19
Q

Why do you need to consider reducing the dose of drugs that work by 1st pass metabolism? Give an example.

A

Liver function is reduced in elderly people

Propranolol

20
Q

What is the equation for creatinine clearance?

A

((140-age) x body weight (kg)/ serum Cr) x 1.23 for men/ 1.04 for woman

21
Q

Why might creatinine be an ineffective marker in elderly people?

A

It is muscle mass dependant

22
Q

What combination of drugs can impair psychomotor function?

A

Opiods

Benzodiazepines

23
Q

What is an important side effect to consider for an elderly person on furosemide?

A

Incontinence

24
Q

What are the most common side effects of medications seen in elderly people?

A

Cognition and consciousness problems
Bowel function especially constipation
Dizziness and balance problems i.e. postural hypotension and parkinsonism (risk of falls/immobility)

25
Q

What are some anticholinergic effects? Give some examples of these medications

A

Confusion, hallucinations, tachycardia, blurred vision, retention, constipation, dizziness, falls, long-term increased risk of dementia
Parkinson’s meds, antidepressants, antiemetics, opiates, antipsychotics, antihistamines

26
Q

What is the ‘anticholinergic burden’?

A

Summative effect of anticholinergic medications

27
Q

What combination of drugs can affect renal function?

A

Antibiotics

ACE inhibitors

Y3 AGEING (8 decks)

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