 | Term | Definition |
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intimacy vs. isolation |
Erik Erikson's crisis of young adulthood (18-34) |
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generativity vs. stagnation |
Erik Erikson's crisis of middlescence (35-64) |
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Peck's 4 Developmental tasks of middlescence |
valuing wisdom vs physical powers; socializing vs. sexualizing; emotional flexibility vs. emotional impoverishment; mental flexibility vs. mental rigidity |
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ego identity vs. despair |
Erik Erikson's crisis of maturity (65 yo +) |
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Peck's 3 stages of maturity |
ego differentiation vs. work-role preoccupation; body transcendence vs. body preoccupation; ego transcendence vs. ego preoccupation |
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activity theory |
a social/psychosocial theory of aging. socially active people adapt more successfully to aging. |
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labeling theory |
social/psychosocial theory of aging; our self-concept is based on how other people define and react to us. |
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stochastic theory |
a biological theory of aging that involves a series of events or phenomena that occur randomly and accumulate with time. |
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nonstochastic theory |
a biological theory that relates aging and lifespan to predetermined or preprogrammed events for the organism |
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free radical theory |
a stochastic, biological theory of aging. that relates to the accumulation of free radicals over time |
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lipofuscin |
a pigmented lipoprotein found in nervous, muscle, and skin (Age or liver spots) tissue caused by free radicals. This tissue interferes with cellular diffusion and transport. |
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cross-link theory |
a biological, stochastic theory of aging. with age, collagen and elsatin develop increased numbers of cross-links and thus become more rigid and dehydrated. Ca deposits accumulate in the collagen and elastin. Results in decreased tissue flexibility and permeability. free radicals also cause DNA to form cross-links. |
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wear-and-tear theory |
a biological, stochastic theory of aging. Cells wear out over time because of the lifelong accumulation of the effects of internal and external stressors to the cells. |
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Programmed aging theory |
a biological, nonstochastic theory of aging. The max cellular life expectancy is genetically determined. A biological closk initiates the aging sequence hen certain limits are reached. |
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Hayflick's principle |
cells double a limited number of times before dying. estimated 40-60 replications in human cells. |
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Thymus |
a gland found behind the sternum, matures the B and T cells of our body, and is thought to be associated with our "biological clock" |
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telomeres |
the tail end of chromosomes that get "shaved" down with cell divisions. thought to be associated with our biological clocks. chronic stress can shorten the length of the telomeres. |
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telomerase |
an ezyme that can lengthen telomeres. cancer produces this and the teleomeres are able to reproduce over and over uncontrollabley. |
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Humoral Immunity |
An immune response by B cells developing into plasma cells that secrete antibodies to attack foreign substances, |
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cell-mediated immunity |
An immune response by T cells and NK cells which can phagocytize foreign bodies or inject them with toxins. they also destroy tumors |
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autoimmunity |
body's immune system stops recognizing the body's own cells and attacks them. |
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suppressor T cells |
our cells found in the cell-mediated immunity which normally tone down and prevent autoimmune reactions. |
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hypothalamus |
a gland that is normally involved in regulating many functions, including temperature, autonomic nervous system, fluid balance, etc. as we age, this and the endocrine system have more difficulty making homeostatic adjustments. |
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Glomerular Filtration Rate |
measured by the creatine clearance of the kidneys. dependent on the blood flow through the kidneys |
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presbyopia |
the loss of accomodation and near vision |
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pharmacokinetics |
drug absorption, distribution, metabolism, and elimination |
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drug absorption |
the movement of a drug from its site of administration into the blood. Influenced by GI motility, first pass effect. |
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drug distribution |
the movement of drugs throughout the body. Influenced by serum albumin |
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serum albumin |
a simple protein in the blood that acts as a carrier molecule. and commonly used to assess for malnutrition. but they have long 1/2 lives and do not always represent current nutritional status |
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drug metabolism |
the enzymatic alteration of drug structure. Influenced by hepatic enzymes |
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Drug elimination |
the removal of drugs from the body. Influenced by kidney function |
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polypharmacy |
multiple drug therapy |
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failure to thrive |
a progressive functional decline, sometimes called the "dwindles" |
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bitter and sour |
the perceived tastes of elderly that outlast sweet and salty, and may affect the nutritional status |
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xerostomia |
dry mouth or decreased saliva production |
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diuretics |
water pills, used to void extra water from the body. Common in patients with heart disease, may lead to dehydration. example: furosemide (Lasix) |
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1500 ml or less a day |
this amount of fluid in older adults is considered to be a risk factor for dehydration. |
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1500 kcal a day |
the minimum intake of calories/energy in older adults a day. failure to reach this may result in health problems |
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10-20% |
the percentage of caloric needs that older adults need of protein. |
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vitamin B12 (cobalamin) |
a vitamin that is found in meats, fish, poultry, dairy, and eggs. the metabolism of this vitamin requires HCl and an intrinsic factor produced by the stomach for absorption. |
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transferrin |
a serum protein that carries/binds Fe. half life of 8-10 days and is a more rapid predictor of protein depletion |
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prealbumin |
a carrier protein (for retinol-binding protein) with a half-life of 2-3 days. this is sensitive to sudden demands on protein synthesis and thus is used in the hospital. |
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reservatrol |
a phytochemical that may produce effects similar to calorie restriction |
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advanced directives |
legal documents used to indicate care wishes and limit the amount of unwanted aggressive treatment and terminal illness. aim to provide "clear and convincing proof" of wishes |
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Patient Self Determination Act (1990) |
a federal law that ensures compliance with state laws concerning advance directives. Requires clients be informed of their right to make decisions about their care. This was part of the Omnibus Reconciliation Act. |
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living will |
aka "declaration to physicians." it is activated only when terminally ill AND death is imminent OR when the person is in a persistant vegetative state |
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durable power of attorney for health care |
a person appointed as a proxy for health care decisions. The proxy is a spokesperson for the patient when he/she becomes incapable of making choices about treatment. goes into effect anytime the person is incompacitated and is not limited to terminal illness. the document can also specify some of the person's wishes |
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guardian |
a court-appointed surrogate who excercises individual rights for a person who is no longer mentally competent. more specifically, they are appointed either limited or full decisional responsibilities. |
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chemical name |
the drug name that describes the chemical structure |
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Generic (nonpropriety) name |
the drug name assigned by the U.S. Adopted Names Council and World Health Org |
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Trade (propriety or brand) name |
drug named assigned by companies marketing the drug |
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first-pass effect |
oral drugs pass through the liver on their way from the GI tract to general circulation. sometimes they are inactivated by the liver enzymes as they pass through the liver. can bypass this effect by giving med via another route. |
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prodrugs |
therapeuticcally inactive drugs that need to be converted to an active form. examples: codeine or acetominophen |
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cytochrome p450 enzymes |
a family of enzymes that metabolize most drugs. |
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lipophilic |
drugs that are lipid-soluble. therefore able to cross the phospholipid bilayers of cell membranes. they also tend to be nonpolar |
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pharmacologic tolerance |
decreased responsiveness to a drug after a long use over time. "drug holidays may be necessary"...example: opiods |
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pharmacodynamics |
the study of the biochemical and physiologic effects of drigs and the molecular mechanisms by which those effects are produced. |
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adverse drug reaction |
response to a drug that is noxious and unitntended (any undersired response to a drug) which occurs at normal drug dosages |
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idiosyncratic response |
a peculiar, unique, or individual response to a drug due to your genetic difference |
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side effect |
an unavoidable secondary drug effect. actions inherent in the drug that produce effects other than the therapeutic action. this is something you can expect to see, but really can't prevent. |
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toxicity |
adverse drug reaction caused by excessive dosing |
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drug half-life |
the time required for the amount of drug in the body to decrease by 50%. determines the dosing interval. |
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plateau |
the steady state reached after 4 half-lives. this is identified when the amount of drug eliminated between doses equals the dose administered. |
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agonists |
drugs that bind to cell receptors and mimic the action of the body's own endogenous molecules. *activate cell receptors |
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antagonists |
drugs that bind to cell receptors and block the action of the body's own endogenous molecules. *prevent receptor activation *often called "blockers" |
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potentiation |
one drug may possibley intensify the effects of the other |
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additive (summative) effects |
when the combined effects of two or more drugs equal the sum of the individual effects of each drug. 1+1=2 |
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synergistic effects |
when the combined effects of two or more drugs is greater than the sum of each individual drug. overall, increases the effect of the other drugs; 1+1=3 |
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inhibitory interactions |
drug interactions result in reduced drug effects (good/bad effects can be reduced) |
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grapefruit juice effect |
the inhibition of cytochrome P450-3A4, an enzyme found in the liver and intestine walls. This inhibits the metabolism of many medications, and can lead to toxicity. The effects can persist for up to 3 days. |
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MAO inhibitor and tyramine |
a toxic drug-food interaction. can cause life-threatening high BP. Vit K, cranberry juice, aged cheese, yeast extracts, and fermented foods. |
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FDA pregnancy categories |
grading system of letters to indicate the level of risk to the fetus. remote possibility of fetal harm: A --> B --> C --> D --> X 9evidence of fetal risk that clearly outweighs any possible benefits |
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bactericidal or bacteriostatic |
an inhibitor to cell wall synthesis or activator of enzymes that weaken the cell wall |
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inhibit cell wall synthesis, alter membrane permeability, impede DNA replication, impair translation of genetic information/inhibit protein synthesis, antimetabolites |
mechanisms of action of antibiotics....this is the basis of their classifications |
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Monobactams |
a new class of narrow spectrum B-lactam antibiotics |
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Carbapenems |
a new class of broad spectrum B-lactam antibiotics |
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Quinupristin and Dalfopristin |
a synergistic combination of antibiotics, streptogramins. they are effective against MRSA, and Vancomycin-Resistant Enterococcus Faecium |
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Polymorphonuclear granulocytes |
neutrophils, eosinophils, and basophils |
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Neutrophils |
55-70% of WBC, increased when bacterial infections are present. Mature cells appear segmented, baby cells appear as bands. |
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agranulocytes |
lymphocytes, monocytes/macrophages |
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T cells |
the most common lymphocyte, it matures in the thymus gland and secretes hormones that regulate T cells. |
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Monocytes and macrophages |
a lymphocyte found floating in the blood until they leave to the tissue. they act as phagocytes and present foreign antigens to lymphocytes |
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inflammatory response |
phagocytosis by neutrophils, monocytes, and macrophages. these cells do not need to attach to specific receptors on the antigens to take action |
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Humoral immune response |
immunity provided by B cells, plasma cells, and immunoglobulins. |
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antigen |
foreign substance that stimulates specific immune response. proteins, polysaccharides, or conjugates |
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hapten |
a substance smaller than an antigen that attaches to an already existing antigen/larger protein so it can be recognized |
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antibody |
made up of protein chains; the Fc stem portion, and the binding site |
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immunoglobulin |
a type of protein in immune system |
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IgM |
the first antibody to appear in an immune response, huge! react with different blood antigens |
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IgG |
the most common antibodies. passable through the placenta. provides passive immunity. aka gamma globulin |
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IgA |
antibodies secreted by the linings of the gastrointestinal, respiratory, and genitourinary tracts. present at any mucosal area |
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IgD |
an antibody that acts in the differentiation of B lymphocytes; otherwise not much is known about |
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IgE |
the antibody that is important in allergic reactions |
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Memory B cells |
B cells that differentiated in order to respond to bacteria that may be encountered in the future. They provide a secondary response in humoral immunity |
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secondary response |
rapid antibody production that occurs following re-exposure to the antigen. IgG is the predominant antibody produced during this. |
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cell-mediated immunity |
the immune response that involves T Helper cells, T Killer cells, NK cells, and cytokines |
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Clonal |
each T-cell bears genetically determined receptors sites for a specific antigen and multiplies rapidly when exposed to the specific antigen. |
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clusters of differentiation |
cell surface proteins that help stabilize interaction between T cells and other cells |
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T Helper cells |
cells that activate macrophages, activate B cells to enhance antibody production, amd enhance cytotoxic T cell function. aka CD4. |
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T suppressor cells |
cells that suppress antibody production and T killer and T helper cell function. They tone down the immune response so the immune system doesn't get carried away. |
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t Killer and NK cells |
cells that release substances that punch holes in the membranes of target cells. effective against virus-infected cells and cancer. found in cell-mediated immunity |
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cytokines |
small proteins produced by immune cells and other cells in the body |
