Wk 4: Pharm: Geriatric

Question 1

BEERS criteria

Answer 1

Improve awareness of polypharmacy

Question 2

Drug interaction

Answer 2

interaction between a drug and another substance

Question 3

Mechanisms that affect drug interaction

Answer 3

absorption, distribution, alternations made to drug by body (metabolsm), elimination from body

Question 4

Drug interactions

Answer 4

Most important come from change in absorption, metabolism, elimination

Question 5

Changes in absorption

Answer 5

alter blood flow to intestines
changes in metabolism in intestines
inc/dec motility
alter stomach acidity
change in bacteria in intestines

Question 6

Drug absorption

Answer 6

can be affected by solubility- ability to dissolve or if another substance binds to a drug and prevents absorption

Question 7

Changes in Drug metabolism/ elimination

Answer 7

Most drugs are eliminated from kidneys either in unchanged form or alter from liver metabolism
Kidney and liver important sites of drug interactions

Question 8

Metabolism

Answer 8

Process through which body converts drug into forms or as a byproduct results from alteration of drug by liver. Most occurs in liver but other organs play a role.

Question 9

How to avoid drug interactions

Answer 9

give HC workers full med list including OTC, herbals and prns

Question 10

Drug interaction factors

Answer 10

genes, physiology, age, lifestyle (diet/exercise), underlying disease, drug dose, duration of combined therapy, relative time of administration.

Question 11

How to avoid drug interactions

Answer 11

1. complete list to HC workers
2. Inform HC when meds are added or DCed
3. Life style chages
4. Ask about serious/frequent interactions
5. Eliminate unnecessary meds, as interactions increase as more meds get added

Question 12

Consequences of drug interactions

Answer 12

inc/dec in beneficial or adverse drug effects

Question 13

Absorption

Answer 13

sometimes increased by foods

Question 14

Prescriptive Authority

Answer 14

1 authoritative source for Ohio Law- OBN.

Major elements:
Title of APRN (CNS, CNP, CRNA, CNM)
Licensure as RN and APRN
Grad accredited school grad 
certification at advanced level from accredited program is maintained
Independent practicing
independent prescribing

Question 15

Medication Reconciliation

Answer 15

Med list is exact, accurate and available, include herbals, OTC, vitamins

Question 16

Match (Medication at transition and clinical handoffs)

Answer 16

AHRQ developed toolkit for medication reconciliation for system use. Make a single med list

Question 17

Geriatric risk factors

Answer 17

falls, medications, physical (wt loss, fatigue, disease), psychosocial (depression, dependancy), and changes (lifestyle, finances, social support)

Question 18

Institute for Safe Medication Practices

Answer 18

Pt safety organization- devoted to patient safety r/t medication error prevention and safe medication use.

Question 19

Polypharmacy

Answer 19

inc medication therapy
delay in ordering med refills
pharmacy pick up of mail delivery
use of multiple pharmacies

Question 20

Most common geriatric med errors

Answer 20

Coumadin, Insulin, antiplatelet, hypoglycemic

Question 21

Non pharmacological factors

Answer 21

use of OTC meds
may play role in drug interactions
obtain good history
good counseling and coordination of services

Question 22

4 basic prinicles

Answer 22

avoid unsafe med practices
recognize meds worseing ADLs
use EBP to determine meds
Consider concomitant disease states- communicate with other services