Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS112 > Week 3 > Flashcards

Week 3 Flashcards

1
Q

How may the absorption of medications change for pts >65?

A
  • increased gastric pH
  • decreased gastric emptying
  • ” Ca++ absorp
  • ” first pass effect
    • increased bioavailability for beta blockers/opiates because fraction of meds aren’t loss as much as younger individuals
  • inhibition of cytochrome P450 pathway
    • increased bioavailability of some drugs(might get too much of drug cos they metabolize slower)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How can metabolism of meds changed for >65 yos?

A
  • decreased blood flow to hepatic circulation
  • decreases metabolism of the drug
    • >half life, especially cardiac drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can distribution of meds change for pts over 65?

A
  • fluctuations in body water volume
  • increase in body fat distribution
    • lipophilic meds include opiates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can excretion of meds change for pts >65?

A
  • decrease
    • creatinine clearance
    • glomerular filtration rate
  • drug clearance reductions
    • amantadine (antiviral for flu)
    • aminoglycosides (gentamycin)
    • atenolol, captopril
    • cimetidine - tagamet
    • digoxin
    • lithium
    • vancomycin
  • reduced renal mass = reduced nephron #
    • renal blood flow down TF GFR down
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What medications are underused?

A
  • ACEI’s
  • beta blockers
  • anticoagulants
  • bisphosphonates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What medications are inappropriate to use in Nursing homes?

A
  • nitrofurantoin
  • amiodarone
  • disopyramide
  • nifedipine
  • ticlopidine
  • cimetadine
  • metoclopramide
  • chlorpheniramine (anti-histamine)
  • NSAID’s
  • Fentanyl
  • Methadone
  • glyburide
  • promethazine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the drug-disease interactions for anti-hypertensives?

A

syncope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the drug-disease interactions for anti-cholinergic?

A
  • BPH
  • constipation
  • dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the drug-disease interactions for ASA?

A

Peptic ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the drug-disease interactions for benzodiazepines?

A
  • dementia
  • falls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the drug-disease interactions for bupropion?

A

siezures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the drug-disease interactions for calcium channel blockers?

A

heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the drug-disease interactions for steriods?

A

diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the drug-disease interactions for opiates?

A

constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the side effects of Aricept (donepezil)?

A
  • nausea
  • diarrhea
  • insomnia
  • falls
  • increased infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Aricept (donepezil) used for and how can it negatively impact pts?

A
  • dementia
  • interacts neg w/ anticholinergics, antidepressants, and some antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effect does digoxin have on elderly?

A
  • antiarrhythmic
    • risk of toxicity
    • reduced drug clearance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What affect does amiodarone have on elderly?

A
  • antiarrhythmic
    • HR drop
    • AVOID
19
Q

Disopyramide effect on elderly?

A
  • induce heart failure
  • AVOID
20
Q

Nifedipine effect on elderly?

A
  • risk for hypotension
  • AVOID
21
Q

What class are Calcium Channel blockers?

A
  • anti-hypertensives
    • can cause heart failure
22
Q

What effects can the anti-hypertensive Calcium Channel Blockers have on the elderly?

A
  • syncope (fainting), dizziness
  • decreases vasodilator therapy
  • HIGH RISK
23
Q

What is the diuretic furosemide (Lasix) effect on elderly?

A
  • neurological issues
  • dizziness
  • hypotension
  • HIGH RISK
24
Q

What are some anticoagulants that effect elderly?

A
  • Pradaxa
  • Xorelto
  • Warfarin (HIGH RISK)
25
Q

What does anticoagulants do to elderly?

A
  • increased sensitivity
  • caution w/ pts >75
  • risk for serious bleeding
26
Q

What are examples of anti-cholinergic meds?

A
  • Ditropan, Detrol
    • overactive bladder
  • Atrovent (COPD)
  • Spiriva, robinal, benadryl, dramamine,
  • chlorpheniramine (anti-histamine), promethazine
    • AVOID
27
Q

What do anticholinergic drugs do to elderly?

A
  • increased cognitive impairment
  • BPH
  • constipation
  • dementia
  • EXCEPT LORATADINE (usually prescribed w/ aricept)
28
Q

What are some common anti-depressants?

A
  • tricyclics-amitriptyline(AVOID)
  • Paxil-paroxetine (AVOID)
  • Celexa, Lexapro, Zoloft (OK)
29
Q

How do anti-depressants affect elderly?

A
  • disoriented
  • confusion
  • impaired thinking/rxn
  • SSRI BETTER CHOICE FOR ELDERLY
30
Q

What are examples of NSAIDS that you should AVOID for elderly care?

A
  • ASA
  • Ibuprofen
31
Q

How do NSAID’s affect elderly?

A
  • peptic ulcers/bleeding
  • dont give w/ anti-coagulants
32
Q

What affect do benzodiazepines have on elderly?

A
  • usually end in -lam, -pam
  • increased sensitivity
  • dementia, falls (sedation)
33
Q

What effect can corticosteroids (HIGH RISK) have on elderly?

A

it can increase blood sugar, possibly leading to diabetes

34
Q

What class are methadone and fentanyl?

A

opiates

35
Q

Effect of opiates on elderly?

A
  • increased bioavailabilty and sensitivity
  • constipation
36
Q

What class is Aricept?

A

cholinesterase inhibitors

37
Q

What are examples of H2 blockers?

A
  • Zantac
  • Cimetadine (AVOID)
  • Pepcid
38
Q

What effect do H2 blockers have on elderly?

A

cause confusion but lower doses okay

39
Q

What can you use thats better H2 blockers than Zantac, Cimetadine, and Pepcid?

A

PPI (Prevacid) or antiacid

40
Q

What is an example of a methylxanthine?

A

Theophylline (HIGH RISK)

41
Q

Why is it riskier to administer theophylline / methylxanthines to elderly?

A

risk of toxity due to reduced clearance of med

42
Q

What does Metoclopramide do to elderly?

A

can cause neurologic disorder

43
Q

What can glyburide do to elderly?

A

prolonged hypoglycemia

44
Q
A

NURS112 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions