how is the GI system affected in regards to pharmacology, with age?
- motility decreases
- Ph increases
- decrease blood flow
- reduced albumin synthesis
how is the cardiovascular system affected in regards to pharm, with age?
- heart muscle weakens
- cardiac output decreases
- bp increases
how is the CNS affected in regards to pharm, with age?
- brain mass decreases
- quantity of neurons decreases (cognition and sensory fx decline)
- BBB more easily penetrated
how is the renal system affected in regards to pharm with age?
- blood flow decreases
- fewer fx neurons
- renal fx declines (GFR decreases)
a decrease in which body system results in prolonged exposure to certain medications?
how is the endoncrine system effected in regards to pharm, w/ age?
- insulin decreases
- production growht hormone declines (increase body fat, decrease lean muscle mass)
Is absorption faster or slower in the elderly?
where is fat soluble drugs stored in the elderly?
the elderly have a _____ concentration of water soluble drugs due to _____ totla-body water.
elderly have a decreased drug bingding to plasma proteins so what does this result in?
increased free drug concentration and greater pharmacologic effect
Elderly have _____ permeability of the bbb and this causes ____ CNS effects
In the elderly the liver fx ____, causing _____ concentration of active drug
Elderly have _____ renal fx, causing increased _____ ______ ______.
serum drug levels
pharmacodynamic deals with? pharmokinetics deal with? match the following to the above:
- pharmacodynamic= effects
- pharmokinetics= concentration
what are some adverse drug rxn in the elderly?
- sudden change in mental status
- rapid weight loss
- changes in body fluid balance
- changes in bowel habits
Beers criteria? I think we all need some beer after all this hell :)
- drugs that have a hgih risk of causing adverse drug reactions
- use of these drugs should be avoided or closely monitored
- nurses should be familiar with the list and potential advrse effects
what adverse rxn due you need to watch out for antihistamines?
sedation, confusion, anticholinergic effects
what adverse rxn do you need to watch out for benzodiazapines?
confusion, depression, anticholinergic effects
what adverse rxn do you need to watch out for digoxin?
rduced ranl clearance can cause serious toxicity
what adverse rxn do you need to watch out muscle relaxants?
sedation, weakness, anticholinergic effects
what adverse rxn do you need to watch out NSAIDs?
photosensitivity, nephrotoxicity, fluid retention --> may lead to heart failure
what adverse rxn do you need to watch out phenytoin
- confusion, ataxia, slurred speech
- (ataxia= loss of control of body movements)
what adverse rxn do you need to watch out tricyclic antidepressents
halucinations, confusion, anticholinergic effects
Inhibiting the physiological action of acetylcholine,
what are 3 reasons adverse drug rxn occur?
- # drugs taken
- age-relaed physiological and anatomic change
- difficulty distinguishing ADRs from normal age related changes
adverse drug reactions
how do you minimize adverse drug reactions?
- simplify drug regimen
- take into account age-related changes
- encourage reporting suspected ADRs
what are some potential barriers to adherence?
how to improve adherence?
- understanding of purpose of meds
- can they afford the med
- willing to make lifestyle change
what can nurses suggest clients use to improve adherence?
- daily or weekly pill boxes
- educate in ways that are easy for them to understand
- recommend ways to simplify regimen
- support from family friends
what is holistic pharmacotherapy
treating the whole person rather than just symptoms
what are the tiers involved in the integration pyramid care model? bottom to top
- psychological social spiritual demension
- cultural and ethnic perspectives
- community enviro factors
- genetic predisposition
- gender determinates
- age corollaries
human DNA is ____% a like?
whats a genetic polymorphism?
two or more versions of the same protein
what is pharmacogenetics?
study of genetic variations that cause differences in way pts handle meds
how can genetic polymorphism affect drug action?
mutated version of enzyme may increase or decrease speed of drug metabolism and excrertion
simple changes in structure can result in ____ protein receptor that no longer "____" drug
receptor polymorphism is associated with an increased risk for what disorders?
- prostate cancer
- breasst cancer
who is mostly like to go to the doctor? men or women? who is less likely to go get medical attention for heart disease?
what sad thing happens to males when they take antihypertensives? what happens if they decide to take themselves off it?
- male impotence--- no erection (sad lil weiner)
- males suffer strokes r/t abruptly stopping the medications
- need to taper it down and educate about it!
who is aspirin more in effective in preventing heart attacks for?