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NURS2518 : The Older Client > week 7 : Pharmacokinetics ( Marck's version) > Flashcards

week 7 : Pharmacokinetics ( Marck's version) Flashcards

1
Q

Age-related changes :
Define if it’s true or false.

Decreased glomerular filtration rate can increase serum levels of medications.

Decrease hepatic flow- liver is involved in the metabolism of medications, herbs, nutrients, and nicotine.

A

both are true of the characteristics

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2
Q

Decreased body water and lean tissue affect serum concentrations of medications

A

true

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3
Q

low serum what lead to changes in the drug’s therapeutic range adverse effects.

A

albumin

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4
Q

True or false. Receptor sensitivity ( different parts of the body) does not enhanced the drug’s absorption, distribution, metabolized, and excreted.

A

false, it does affect it.

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5
Q

what do you have to think about in functional changes in older adults ?

A

think about culture, spiritual, ( sensory perception) they cannot see as well affects their functional ability = higher chances of dosing errors
cognition issue may not remember to take their medications

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6
Q

Pharmacokinetics :

ADME
describe each of it.

A

A= medication is absorbed into blood stream, tissue or both

D = once medication is absorbed it is transferred to the target organ to be effective

M= converts mediation to a compound that can easily be excreted

E= medications are excreted through saliva, urine, or sweat

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7
Q

What are the changes in the older adults body that might impact the time it takes for the drug to absorbed ?

A

diminished gastric acidity
slower stomach emptying ( diminish activity of short lived medications)

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8
Q

Is it true or false, that slowed gastric emptying can increase the effect of the medication

A

true

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9
Q

How do the changes in the older adult’s body change the absorption of the medication?

A

time delay in maximum drug concentration

transdermal may lead to decreased concentration of drug in the blood

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10
Q

true or false. Fosamax can not be taken with food?

A

true

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11
Q

Pharmacokinetic properties : distribution

how does the body influence the distribution of the drug or its transportation to the target organ?

A

amount of plasma protein
amount of available fat
availability of water in the body
some drugs have a narrow therapeutic window

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12
Q

what are the changes in the older adult body that might change the distribution?

A

changes older adults changes in body composition increased body fat and deceased body water

effect : drugs that bind to body fat will have prolonged effect e.g ( diazepam)

effect : drugs that bind to water will have an increased effect

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13
Q

Older adults who with prolonged illness or malnutrition can have a decrease in what ?

A

Plasma protein

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14
Q

Decrease in plasma protein increases the activity of the medication and can lead to toxic levels of medication. True or false.

A

true

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15
Q

What is the the process in which the body modifies the chemical structure of the medication?

A

metabolism

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16
Q

What changes the chemistry of the drug so it can be excreted?

A

metabolism?

17
Q

what is half life, under metabolism ?

A

time it takes for the concentration of the drug in the plasma or the total amount in the body to be reduced 50%.

18
Q

How do the changes in the older adult’s body change the metabolism of the drug ?

A

change : reduced in blood flow through liver
effect : can lead to an increase in the amount of the time, the medication stays in the body longer ( increasing the half life )

19
Q

what is the most significant age-related changes that are related to older adults?

A

metabolism and excretion

20
Q

changes in metabolism can include decreased flow of blood through the liver and can lead to increased what ?

A

increased in half life of medication

21
Q

changes in the excretion are decreased kidney function which can increase the older adult’s risk for ?

A

drug toxicity

22
Q

Polypharmacy is use of more medications than is clinically indicated ?

A

yes that is true

23
Q

This is often associated with the chronic use of 5 or more medications

A

polypharmacy

24
Q

A large number of medications, contraindicated, potentially inappropriate or medications that are duplicated or unnecessary

A

polypharmacy

25
Q

what are the top 10 drug classes prescribed to seniors

A
  1. HMG - CoA reductase inhibitors
  2. proton pump inhibitors
  3. ACE inhibitors
  4. beta- blocking agents, selective
  5. Dihydropyridine
  6. thyroid hormones
  7. angiotensin II antagonists, excluding combinations
  8. Natural opium alkaloids
  9. biguanides
  10. benzodiazepine derivates
26
Q

Risk factors : increased consumption of bioactive substances increases the risk for adverse effects , is this true ?

A

yes it is true

27
Q

Pathologic processes and functional impairments, behaviours based on misunderstanding and myths , communication barriers, lack of information, inappropriate prescribing practice (beers criteria)

A

these are the risk factors

28
Q

risk factors exert a stronger influence in older adults than age related changes

A

true

29
Q

factors that increase the risk for adverse medication effects

A

increased number of medications
frailty
malnourishment dehydration
multiple illnesses

30
Q

reduce polypharmacy using ( AGS ) Beer’s Criteria

A

compendium of medications potentially to avoid or consider with caution because they often present an unfavourable balance of benefits and harms for older people

31
Q

reduce polypharmacy using ( GCS) beer’s criteria

what are the 5 criteria we must know`

A
  1. Avoided by most older people
  2. Avoid by people with specific health conditions
  3. avoided in combination with other treatments because of the risk of harmful drug drug interactions
  4. Used with caution because of the potential for harmful side effects
  5. Dosed differently or avoided among people with reduced kidney function, which impacts how the body process medicine.
32
Q

deprescribing :

A

dsicontinuing drugs

33
Q

risk of antipyschotic medications

A

cause orthostatic hypotension

anticholinergic effects

impacts ability of the older adult to thermoregulate

34
Q

Risk of antipyschotic medications :

unlikely to see ( or should not be used as ) first geenration psychotics such as haloperidol, perphenazine or chlorpromazine in a person with dementia

A

true

NURS2518 : The Older Client (13 decks)

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