CH 17 Rx for the elderly

  1. What rx changes in older adult
    • Pharmkinetics
    • NOT dynamics (what drug does to body)
  2. Age-related changes
    • Less % water body weight, lean muscle mass, blood flow & albumin
    • Increased in body fat (lipophilic meds such as benzos means fat will store and half life will be longer)
  3. What are 4 highly protein (albumin) bounds meds
    • Warfarin (99%
    • Diazepam
    • Valproic acid
    • Phenytoin
  4. What is the caffeine half life and what kind of molecule is it
    • 1.5-9 hours
    • max 15 min in younger and 100 in older
    • CYP450 1A2 substrate
  5. What meds to avoid in elderly
    systemic antiicholinergic, urinary retention, constipation, visual dis, and hypotension
  6. What non-psych anticholinergic med do we not like to use
    Oxybutynin for overactive bladder due to highest systemic anticholinergic
  7. What psych meds we do not like to use
    TCAs and some SSRIs (Fluoxetine and Paroxetine)
  8. Citalopram not rec when, options?
    • bradycardia, recent MI, uncomp HF, HYPOK/Mg
    • or hepatic impairment
    • and PPIs!!
    • Do escitalopram (1/2 dose gives still therapeutic)
    • only SSRI that has 0 drug to drug interaction
  9. Which is the only SSRI with 0 med to med interaction
  10. How much does 1 unit of insulin reduce BG by
    50 units
  11. Med to dc 80yo+ and no cardiac hx
    • aspirin dc due to GIB
    • used a primary prevention but dc!
  12. All PPIs are what
    CYP450 2C19 inhibitors
  13. ABx meds high for what in elderly
    • HYPERKalemia
    • trimethoprim-sulfamethoxone
    • (Bactrum)
  14. Dementia meds are associated with what
    • cholinesterase inhibitors -->
    • bradycardia, pacemaker, hip fx, syncope
Card Set
CH 17 Rx for the elderly
CH 17 Rx for the elderly