Psychopharm in Elderly Flashcards
The 2nd most prescribed drug in elderly?
Psychotropics
Pharmacotherapy in elderly may be complicated by: (5)
Polypharmacy Cognitive impairment Coexisting medical conditions Age related physiological changes (kid/liv) Reduced funxn capacity (can't open!)
Changes in the proportion of these two effect distribution of drugs.
Body water & fat
If body water is lower:
Water soluble drugs have a reduced volume
In the case of lithium in elderly?
Higher serum levels
Because of larger portion of fat in elderly, drugs that are fat soluble are distributed:
In larger volume, and may result in slower elimination & prolonged action.
Decline in kidneys leads to…
Slowed excretion
Liver changes…
Impede breakdown of drugs
T/F Geriatrics tend to be less sensitive to side effects of psychotropics.
FALSE - More sensitive RT change in receptor function.
Geriatrics are _______ vulnerable to side effects.
More - postural hypotension, sedation, EPS, dizziness & tricyclic cardiac fx
Geriatrics are also at higher risk of this dance craze.
Drug induced psychosis - higher risk of Atropine psychosis!
We need to make the following adjustments in elderly meds:
Lower doses & slower escalation of any doses
T/F We should use tricyclics.
NO!! Use other than tricyclics RT cardiac effects
We should use antipsychotics that are…(2)
Less sedating
Less likely to produce hypotension & anticholinergic effects
So which antipsychotics should we use smart guy?
Hi-potency & Atypicals
