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Geri Test 3-Pharmacology*
Terms in this set (25)
This is a long, pretty generic lecture. I only picked out things I thought weren't 100% common sense and may be testable.
T/F- oral formulations of drugs are absorbed as well in old age as in youth
True. In the absence of any issues
What are the 4 components of pharmacokinetics?
What is the volume of distribution of a drug heavily influenced by?
Proportions of lean body mass vs fat
In elderly, lipid-soluble drugs have a greater volume of distribution b/c they have more fat.
T/F- the bound concentration of a drug is the pharmacologically active portion
False. The unbound concentration is pharmacologically active
What things may alter drug distribution in the body?
Decreased total body water, lean body mass and serum albumin
Altered protein binding
Reduction in hepatic metabolism of drugs can be as large as what % over the life span?
Which physiological change may lead to decreased clearance of drugs by the liver?
Decreased hepatic blood flow
What things decrease drug metabolism?
Liver blood flow
What creates serum creatinine in the body?
What things can alter renal drug excretion?
Renal blood flow
Glomerular filtration rate
Tubular secretory function
What are normal pharmacodymanic changes that occur with aging?
Alterations in receptor number, receptor affinity, second messenger function, cellular responses
T/F- On average the elderly take more prescription drugs than the general population
Elderly take what % of all drugs?
25-40% of all OTC meds
Nursing home pts take 8-10 meds
What factors contribute to polypharmacy?
Lack of primary care giver
Problems with vision or hearing
Multiple chronic medical problems and vague sxs
Pt pressure to Rx a pill for every ill
What are factors associated with medication related problems?
Presence of >6 chronic medical problems
>12 doses of meds/day
≥9 med use
Low body weight or body mass index
Creatinine clearance <50 ml/min
What % of hospitalizations among seniors are due to adverse medication rxns?
6x that of the general population
What are 5 primary goals of drug therapy?
Alleviate pain, suffering, disability
Improve functional capacity
Promote quality of life
Prevent iatrogenic dz
T/F- have pts "brown bag" all meds at each visit
True. It is important to review them all of them at each visit
What should we strive for when prescribing medication?
One dz, one drug, once a day
What are the most common meds associated w/ adverse drug withdrawal events (ADWEs)?
T/F- All drugs have adverse drug rxns
What are types of noncompliance?
Taking doses at wrong time
Incorrectly administering the meds
What are things that factor into noncompliance?
Attitudes about illness, aging and meds themselves
Meds may be a reminder of illness and growing older, pt may resist or ignore meds
Living alone w/ no support system to remind them to take meds
Ways to maximize pt compliance to meds?
Use pt education materials for elders
Watch pt administer the meds
Refer to pharmacist for compliance aids
Suggest reminder aids like calendars, med boxes
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