Polypharmacy- Lecture 9 Flashcards
Types of interactions
nutrient-drug, drug-nutrient, drug-drug
consequences of polypharmacy
nutritional deficiency, drug toxicity, loss of drug efficacy, increase risk of falls
Types of medications
nervous system, alimentary tract and metabolism, cardiovascular medications
Age related physiological changes related to pharmacokinetics
absorption, distribution, metabolism, excretion
Drugs and food intake
changes in appetite, food selection, taste, smell, adverse GI effects
Dysgenia
abnormal, unpleasant taste sensation
Mechanisms of altered absorption
altered rate of gastric emptying, intestinal motility, splanchnic blood flow, altered secretion of bile, gas and digestive juices
etiology of dehydration
illness, swallowing problems, less sensitive to thirst, depression, dementia, decreased motility impairs access to water, fears of incontinence -> restricted intake
Effects of dehydration
upper body weakness, speech difficulty, confusion, dry mucous membranes, dy tongue, sunken eyes in sockets, increased susceptibility to UTI and pneumonia, pressure ulcers
Percentage dehydrated in LTC?
97.5%
Average fluid intake in LTC?
900 mL (recommended is 1500 mL/d) - best at breakfast
Factors affecting fluid intake in LTC
inadequate staffing and supervision, presence of dysphagia, cognitive/functional impairment, lack of family assistance, inability to speak english
Factors that contribute to fluid intake
water intake is associated with medication and meal frequency, diminished thirst mechanism and functional dependency, lack of familial support and insufficient staff
Nutrition intervention for dehydration
minimum 1500 mL/ d, sips can improve oral health and hydration status at the same time, other beverages provide added nutrients
Best practices for hydration in LTC
policy on hydration, hot weather policy, identify risk factors, educate staff on S and S of dehydration, procedures to monitor and corrective action
