Principles of Geriatric Pharmacology

Question 1

What pharm principal will not change in geriatrics

Answer 1

drug absorption

not significant but
decreased gastric acid, gastric emptying/GI motility, decreased splanchnic blood flow

Question 2

 Patients over 65 yrs account for _____ of prescription drug use

Answer 2

30-40%

Question 3

Pharmacokinetics distribution in geriatrics

Answer 3

decrease in TBW and lean body mass, increase in fat

decreased Vd for water soluble drugs and prolonged elimination and accumulation for lipid soluble drugs

Question 4

Decrease in hepatic mass and blood flow at rate of 1%/yr after age 40–>

Answer 4

decreased 1st pass metabolism

Question 5

_____ reactions appear to be minimally affected by aging, but Phase I decreases with age in 30-35% of elderly

Answer 5

Phase II

choose Phase II metabolized drugs over Phase I since it is less affected

Question 6

Renal function declines predictably (_______)

renal dosing adjustments should be used regularly

Answer 6

Cockroft-Gault equation

about 10 ml/decade

Question 7

defines explicit criteria for determining potentially inappropriate mediation use in elderly

Answer 7

Beers List

drugs are categorized as medications to avoid or to use within dose and duration ranges in the elderly OR medications to avoid in elderly patients with specific concomitant diseases

Question 8

“discontinue _______” is always the right answer!

Answer 8

amitriptyline

Question 9

Drugs old people need to avoid

Answer 9

Avoid diphenhydramine, 1st gen antihistamines, Class I antiarrhythmics; digoxin >.125 mg/day

Question 10

What are pharmacodynamic difference

Answer 10

What the drug does to the body

Question 11

What are pharmacokinetics

Answer 11

what the body does to the drug

Question 12

STOPP

Answer 12

Screening Tool of Older Person’s potentially inappropriate Prescriptions

Question 13

START

Answer 13

Screening Tool to Alert doctors to Right Treatment

Question 14

Non specific geriatric s/e

Answer 14

Weight loss
Falls
Decline in function 
Delirium 
Constipation

Question 15

ABSOLUTE RISK REDUCTION RELATIVE RISK REDUCTION

Answer 15

this is on the test

Question 16

Number needed to treat

Answer 16

NNT= 1/ARR

Question 17

Relative risk reduction

Answer 17

RRR= 1 - Relative Risk

Question 18

Absolute risk reduction

Answer 18

ARR= [c/(c+d) ] - [ a/ (a+b)]

Question 19

Number of patients who need to be treated for 1 patient to benefit

Answer 19

Number needed to treat

Question 20

The difference in risk (not the proportion) attributable to the intervention as compared
to a control

Answer 20

Absolute risk reduction

Question 21

The proportion of risk reduction attributable to

the intervention as compared to a control

Answer 21

Relative Risk Reduction

Question 22

used in case-control studies

Answer 22

Odds ratio

Question 23

Used in a cohort study

Answer 23

Relative Risk