Sync Exam 1 Flashcards
What percentage of older adults are taking at least 1 medication?
> 90%
What percentage of older adults are on poly pharmacy (5+ meds)?
> 40%
When should medication gathering be completed?
History (subjective exam)
What is medication review?
Review of all medications a patient is currently taking
What is medication reconciliation?
Noting any errors to what the patient is taking and what they are supposed to be taking
Prescribing cascade
Taking a drug to treat a side effect from a drug
What errors do you want to avoid in medication reconciliation?
Duplications, omissions, dosing errors, and drug interactions
What is omission?
Medication a patient is taking that is not listed
What is commission?
A medication a patient is not taking that is listed
What are the steps for medication reconciliation?
Assemble list of current meds
Confirm a list of prescribed meds
Compare two lists
Identify any concerns
Communicate concerns to caregiver
Who is the beers criteria intended for?
Prescribing providers and adults 65+
What are the causes of cholinergic meds?
Increased parasympathetic activity (wet, relaxed)
What are the causes of anticholinergic meds?
Decreased parasympathetic activity (dry, fight or flight)
What is a common symptom caused by anticholinergic meds?
Sedation, drowsiness, and confusion
What does an agonist have?
Both affinity and efficacy
What does an antagonist have?
Only affinity
What are partial agonists?
Create a less than optimal response even though they are capable of occupying receptors
Tachyphylaxis
Acute decrease in drug efficacy often due to repetitive/rapid dosing (dose must be increased to meet same effect)
What type of pole does acetic acid have?
Negative
What type of pole does dexamethasone have?
Negative
What type of pole does hydrocortisone have?
Positive
What type of pole does lidocaine have?
Positive
When are drugs more easily absorbed?
In their nonionized form
How are weak acids absorbed?
Easily from the stomach
How are weak bases absorbed?
Easily from the duodenum
What does ionized equal?
Polar
What tends to happen to polar drugs?
They are excreted
What tends to happen to non polar drugs?
They are re absorbed
What are the non biological DMARDs used to treat malaria?
Chloroquine
Hydroxychloroquine
Sulfasalazine
Methotrexate
Leflunomide
What do biological DMARDs do?
Blunt autoimmune response but also make patient immunocompromised
What are types of biological DMARDs?
Etanercept (enbrel)
Adalimumad (humira)
Infliximab (remicade)
What is used for pain control in osteoarthritis?
Tylenol, NSAIDs, intra-articular steroids, and glucocorticoids
