Polypharmacy Flashcards
What are the symptoms of anticholinergic ADR’s?
Confusion, dry mouth, constipation, blurred vision, urinary retention and orthostatic hypotension
What are the symptoms of a tricyclic ADR?
Confusion and unsteady gait
How do Adverse Drug Reactions look like in the elderly?
Unsteadiness Dizziness Confusion Nervousness Fatigue Insomnia Drowsiness Falls Depression Incontinence
How might hyperthyroidism present in elderly patients?
Depression Cognitive Impairment Muscle Weakness Atrial Fibrillation Heart Failure Angina
What drugs cause the most adverse effects?
Anticholinergics and Sedatives
What effects do ageing have on drug distribution?
Reduced muscle mass and increased adipose tissue may increase duration of action of fat soluble drugs
Reduced body water increases serum levels of water soluble drugs
Decreased albumin increases serum levels of acidic drugs
There is increased permeability across the blood brain barrier
How does age affect metabolism?
Decreased liver mass and blood flow effects hepatic metabolism and reduces first pass metabolism and increases toxicity
How does ageing affect drug excretion?
Renal function decreases with age and reduces clearance = increased half life and toxicity
Why does ageing cause a sensitivity to certain medicines?
Change in receptor binding, decrease in receptor number
What are the principles of prescribing for older people?
Be clear about diagnosis to avoid prescribing uneccesary drugs Consider if drug therapy is best option Low dose may be needed Review doses regularly Keep regimens simple