Prescribing In The Elderly

Question 1

Acidic drugs need what sort of environment?

Answer 1

Acidic for absorption

Question 2

Basic drugs need what sort environment for absorption?

Answer 2

Basic

Question 3

Examples of acid drugs?

Answer 3

Phenytoin
Aspirin
Penicillins

Question 4

Examples of basic drugs?

Answer 4

Diazepam
Morphine
Pethidine

Question 5

Do elderly patients have an increased or decreased gastric pH?

Answer 5

Increased - less acidic - means they absorb basic drugs better than acidic

Question 6

Is albumin acidic or basic and what does it Bind to?

Answer 6

Basic

Binds to acidic drugs

Question 7

Is alpha -1- acid glycoprotein acidic or basic and what does it bind to?

Answer 7

Acidic

Binds to basic drugs

Question 8

In what proportion do elderly patients have albumin and A-1-AG?

Answer 8

Low albumin

Higher A-1-AG

Question 9

Elderly people’s liver function?

Answer 9

Reduced due to decreased liver size, blood flow and disease

Question 10

Do elderly people have increased or decreased GFR ?

Answer 10

Decreased

Question 11

Does narrow therapeutic window become bigger or smaller as person gets older?

Answer 11

Smaller

Question 12

What quantifies narrow therapeutic window?

Answer 12

<2

Question 13

Which drugs have a narrow therapeutic window?

Answer 13

Theophylline
Warfarin 
Lithium
Digoxin
Gentamicin
Vancomycin
Phenytoin
Cyclosporin
Carbamazepine

Question 14

What type of drug interactions exist?

Answer 14

Drug drug
Drug food
Drug disease
Drug side effects
Drug toxicity

Question 15

Clopidogrel and what?

Answer 15

PPIs

Question 16

ACEi increase hypoglycaemic effect of what?

Answer 16

Sulfonylureas

Question 17

TCAs and what?

Answer 17

Type 1 anti-arrhythmic

Question 18

Theophylline and what?

Answer 18

Macrolide antibiotics

Question 19

Statins and what ?

Answer 19

Macrolides

Fibrates

Question 20

Dementia and what?

Answer 20

Gingho Bilbba

Question 21

OA and what?

Answer 21

Glucosamine

Question 22

Depression and what?

Answer 22

St. John’s wort

Question 23

Asthma and what?

Answer 23

Beta blockers

Question 24

Parkinson’s and what?

Answer 24

Drug induced confusion

Question 25

Constipation is worsened by?

Answer 25

Calcium Anticholinergics CCB

Question 26

What drugs lower seizure threshold?

Answer 26

Neuroleptics Tramadol Quinolones

Question 27

What do grade fruit, Apple, orange, cranberry Inge react with and why?

Answer 27

Statins Antihistamines Cytochrome P450

Question 28

What does chicken, turkey, milk, soy, cheese, yoghurt interact with and why?

Answer 28

Antibiotics Thyroid meds Digoxin Diuretics. Alter the pH

Question 29

What do bananas , oranges, green leafy veg interact with and why?

Answer 29

ACEi ARBs K sparing diuretics K+ Rich