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Pharmacology in elderly
Terms in this set (7)
Most drugs are passively absorbed in SI so not much effect. Absorption of some drugs, ie Phenytoin, are reduced by NG tube feeding.
Decreased Vd (total reduction in body H2O) - increased conc of water-soluble drugs
Increased body fat % - larger Vd, increased elimination t0.5 of lipophilic drugs, e.g. diazepam
Reduction in albumin - increases unbound levels of drugs like warfarin, phenytoin
Reduced CO -> reduced hepatic blood flow + reduced hepatic mass => Reduced hepatic metabolism of drugs
LFTs do not assess effectiveness of hepatic drug metabolism.
Be careful with drugs that have narrow TI - Phenytoin, Warfarin, Theophylline
Renal elimination is reduced => increased t0.5
DON'T use creatinine alone to assess renal function (elderly have low muscle mass hence baseline creatinine will already be low hence masking renal impairment)
Use creatinine clearance or GFR instead
Reduce doses of renally excreted drugs e.g. Digoxin, Gentamycin, Theophylline
Older people are more sensitive to medicines and effects
Exceptions - e.g. myocardial B1 adrenoceptors are down-regulated which decreases response to B-blockers
Similar to Beers' criteria but better
Prevents inappropriate prescribing of medicine in elderly
Prevents prescribing omissions
This set is often in folders with...
Senescence in cells
Ageing in humans
Frailty & Sarcopaenia
Advanced communication in elderly
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