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kyleannkelsey
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Why should Benzos and Non-benzo hypnotics be avoided in geriatrics?
Risk of cognitive impairment, delirium, falls, fractures and MVAs
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Why should Estrogens w/ or w/o progestins be avoided in geriatrics?
Carcinogenic, lack of cardioprotection in older women
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Why should sliding scale insulin be avoided in geriatrics?
High risk of Hypoglycemia
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Why should sulfonylureas be avoided in geriatrics?
- Prolonged half-life
- Severe prolonged hypoglycemia
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Why should Non-Cox selective NSAIDs be avoided in geriatrics?
Increased risk of GI bleed
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Why should skeletal muscle relaxants be avoided in geriatrics?
- Poorly tolerated
- Anticholinergic
- Sedative
- Risk of Fracture
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What are the first generation Antihistamines?
diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist), chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane)
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What is the brand name for nitrofurantoin?
Furadantin, Macrobid, Macrodantin
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What are the Alpha 1 blockers?
- Ending: -osin
- Doxazosin (Cardura), Prazosin (Minipress), Terazosin (Hytrin)
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What are the Alpha agonists:
- clonidine
- guanabenz
- guanfacine
- methyldopa
- moxonidine
- What are the tertiary TCAs?
- -tryptiline
- -pramine
- -pin
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What are the Non-Benzodiazapine Hypnotics?
- Z drugs:
- -clone
- -plon
- -pidem
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What drugs should be avoided in HF with geriatrics?
- NSAIDs
- COX-2 inhibitors
- Non-dihydropyridine CCBs (only for systolic HF) (diltia/verap)
- TZDs
- Cilostazol
- Dronadarone
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What drugs should be avoided in geriatrics with Syncope (loss of consciousness when standing up)?
- ACHEIs
- Peripheral alpha blockers
- TCAs
- Olanzapine
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What drugs should be avoided in epilepsy?
- Bupropion
- Clozapine
- Olanzapine
- Tramadol
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What drugs should be avoided in geriatrics with insomnia?
- Oral decongestants
- Stimulants
- Theobromines
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What drugs should be avoided in geriatrics with Dementia?
- Anticholinergics
- Benzodiazapines
- H2 Antagonists
- Zolpidem
- Antipsychotics
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What drugs should be avoided in geriatrics with CKD (Stages IV and V)?
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What drugs can be use alternatively to Meperidine or pentazocine?
- Morphine
- Oxycodone
- Fentanyl
- Hydrocodone
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What drugs can be used instead of Glyburide or Chorpromamide?
Glipizide or Glimeperide
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What drugs can be used alternatively to Diphenhydramine?
Loratadine, Fexofenadine, Cetirizine
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What drugs are used alternatively to Amitryptiline or Doxepin?
SSRIs
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What drugs are used alternatively to NSAIDs (non-COX selective?
APAP and Celecoxib
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What drugs can be used alternatively to Methyldopa, Resperine, Doxazosin or Clonidine?
ACEIs, Diuretics or CCBs
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What three questions should you ask to tell if a medication is unnecessary?
- Is there an indication for the medication?
- Is the medication effective for the condition?
- Is the dosage correct?
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What questions might you ask to evaluate medication adherence?
- What difficulty do you have taking your medications?
- What types of bottles or packages are difficult for you to open?
- How would you describe your eyesight and hearing?
- What medications did you take yesterday, when did you take them and how many did you take each time?
- How often have you taken medication X in the last week?
- Why are you taking medication X?
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What questions should you ask to assess and monitor drug therapy?
- Does drug match problem list?
- Is drug effective?
- Benefits outweigh risks?
- Is there therapeutic duplication?
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What patients should you target for medication evaluation?
- Insulin, warfarin, digoxin
- Recent hospitalization
- History of an adverse drug reaction
- History of a fall
- Advanced age (85 or older)
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