Prescribing and polypharmacy Flashcards
what could you change for a patient on many drugs with angina, hypertension and heart failure
take them off other drugs and just put on a beta blocker
what GI drug are elderly people commonly on but don’t need to be
why were they on it in the first place
PPI (omeprazole)
bc they were previously on a NSAID so needed protection (now aren’t on NSAID so why they still on it?)
which pain relief medication should elderly be taken off of because of its increased falls risk
opioids
which sleeping pill should elderly be taken off
zopiclone
which blood thinner (anticoagulant) has a low therapeutic index so should be taken off/monitored in elderly
warfarin
which heart medication has a low therapeutic index and hence should be taken off/monitored in the elderly
digoxin
which antibiotics should we avoid in the elderly
why
4C antibiotics - co-amoxiclav, cepahlosporins, clindamycin, quinolones
elderly at higher risk of c diff
what is the definition of NNT
not specific to elderly lol
number needed to treat
the number of patients needed to be treated with a drug to prevent an adverse outcome occurring
what is the significance of ADME in the elderly
ADME - absorption, distribution, metabolism, excretion
generally leaves more of the drug in their bodies compared to adults = why we give elderly lower doses
drugs with low therapeutic index (hence need monitored in elderly) (10)
remember acronym
lithium, gentamicin, digoxin, vancomycin, carbamazepine, theophylline, cyclosporin, warfarin, levothyroxine, phenytoin
acronym - little grannies develop vicious complications treated carelessly with lots (of) pills
what fruit shouldn’t be eaten with statins
grapefruit
what fruit shouldn’t be eaten with warfarin
cranberry
which antibiotic shouldn’t be mixed with alcohol
metronidazole
warfarin and …. drug high a high GI bleed risk
NSAIDs
what can ACEi and spironolactone cause
hyperkalaemia
