Polypharmacy and prescribing Flashcards
Acidic drugs absorb in acidic environments and basic drugs absorb in basic environments. True or false
True
As you get older, what happens to the pH in your stomach
The pH increases, stomach becomes more basic and less acidic
What is a consequence of losing stomach acidity
The absorption of basic drugs increases eg morphine, dizepams and pethidine and this increases risk of delirium
Albumin is an acidic protein and binds basic drugs. True or false
FALSE
Alpha 1 glycoprotein is an acidic protein and binds basic drugs. true or false
TRUE
Elderly people have high levels of albumin, true or false
FALSE
Elderly people have a greater proportion of fat than muscle and so accumulate more lipophilic/hydrophilic drugs
Lipophilic drugs accumulate in fat
If Vd is large, is the drug more lipophilic or hydrophilic
Lipophilic
the greater the Vd, the more lipophilic the drug, the longer the half life, true or false
TRUE
What happens when an elderly patient becomes cachectic
They break down fat and all the lipophilic drug that was stored in fat and so experience side effects and possibly delirium
How do you calculate the therapeutic index TI
lethal dose 50 / effective dose 50
What are the 3 categories for BEERs criteria
- Always avoided
- potentially inappropriate
- used with caution
what is the STOPP-START tool
stop inappropriate drugs and start appropriate ones
What are side effects of drugs with anti-cholinergic activity
blurred vision constipation urinary retention confusion hallucinations tachycardia dizziness falls
Which drugs display anti-cholinergic activity
Parkinsons drugs antidepressants antipsychotics antihistamines antiemetics opiates
