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Jason's MD3 Aged Care-Palliative > Polypharmacy > Flashcards

Polypharmacy Flashcards

1
Q

What is polypharmacy?

A

Not just about numbers

More to do with the indications for conditions

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2
Q

Why do we have polypharmacy?

A

Pain
Comorbidities
Age

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3
Q

Adverse effects of polypharmacy?

A 
Increased falls
Renal impairment
Bleeding
Delirium
Risk of death
Constipation
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4
Q

Issues related to polypharmacy

A

Cost

Missed prescription: miss due to already on lots of drugs

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5
Q

Why is polypharmacy important?

A

Because it’s potentially reversible

Can prevent if thought of early.

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6
Q

Why are elderly more at risk from polypharmacy?

A

Homeostasis
Altered pharmacodynamics
Altered pharmacokinetics

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7
Q

Why younger person get poly pharmacy?

A

Addiction
Psychiatric
Diabetes

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8
Q

Distribution affected by age how?

A

Less muscle, less fluid (dehydrated), more fat

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9
Q

How does more fat affect pharmacokinetics?

A

Sequestered into fat and takes longer to get rid of it

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10
Q

How does being ‘dryer’ affects drugs in elderly?

A

Higher serum

Lower volume of distribution

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11
Q

How is albumin affected in polypharmacy in elderly

A

Negative acute phase reactant

Albumin decreases, less bound to protein and more serum levels.

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12
Q

4 phases of pharmacokinetics?

A

Ingestion
Distribution
Metabolism
Excretions

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13
Q

Metabolism in elderly of polypharmacy?

A

Reduction in hepatic blood flow (affects 1st pass metabolism)
Oxidative pathways affected

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14
Q

Excretion in elderly polypharmacy

What formula for

A

All elderly are renal insufficient

Cockcroft-gault formula for renal impairment in elderly

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15
Q

Pharmacodynamics affects elderly how?

A

Inhalation all
Opioids
Exaggerated effect

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16
Q

Issues with compliance of meds in elderly

A 
Complexity
Visual, hearing impairment
cost
Philosophy
Side effects
17
Q

Medication history taking important points? Comprehensive

A 
Chronology
Knowledge - do they know why and what?
What's started
What's stopped
What's changed
18
Q

What is Med reconciliation?

A

Is there indications for all their comorbidities?

19
Q

Common medications in elderly?

A 
Anti-hypertensives
Analgesics
Anticoagulants
Anti depressants/psychotics
Antibiotics
20
Q

What is dothiepin?

A

Older Tricyclics antidepressant

21
Q

What is hexamine hippy rate?

A

Urine acidifier

22
Q

Celecoxib SFx?

A

Cardiac/renal SFx

Na and H20 retention

23
Q

What is dothiepin?

A

Older Tricyclics antidepressant

24
Q

What is hexamine hippy rate?

A

Urine acidifier

25
Q

Celecoxib SFx?

A

Cardiac/renal SFx

Na and H20 retention

Jason's MD3 Aged Care-Palliative (18 decks)

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