Aging

Question 1

What leads to changes in drug distribution in the elderly?

Answer 1

1. decreased TBW
2. decreased lean body mass
3. increased body fat

Question 2

What changes contribute to mental status changes and pronounced CNS effects in the elderly?

Answer 2

1. decreased weight and volume of brain
2. decreased blood flow

Question 3

Why do the elderly have increased incidence of diabetes?

Answer 3

glucose intolerance leads to increased fasting and postprandial glucose

Question 4

Why do the elderly have an increased incidence of thyroid disorders?

Answer 4

thyroid gland atrophies with age leading to low T3

Question 5

What does a decreased first-pass metabolism in the elderly lead to?

Answer 5

1. increased serum concentration of hepatically cleared drugs
2. decreased activation of prodrugs

Question 6

What does decreased CrCl and GFR in the elderly lead to?

Answer 6

increased bioavailability of renally cleared drugs

Question 7

What are the I’s of geriatrics?

Answer 7

1. immobility
2. incontinence
3. infection
4. inanition
5. impaction
6. impairment of senses
7. instability
8. intellectual decline
9. impotence
10. immune deficiency
11. insomnia
12. iatrogenesis

Question 8

What is our mantra?

Answer 8

Any symptom is a medication problem until proven otherwise

Question 9

What are ADLs?

Answer 9

1. bathing/dressing
2. toileting
3. walking
4. eating

Question 10

What are IADLs?

Answer 10

1. handle money
2. handle medicine
3. use phone
4. prepare meals
5. travel
6. shop
7. housework

Question 11

What drugs can impair bone and muscle integrity?

Answer 11

1. glucocorticosteroids
2. long-term PPIs
3. phenytoin

Question 12

What can be done to improve bone and muscle integrity?

Answer 12

1. Vitamin D
2. Calcium
3. Bisphosphonates
4. resistance exercises

Question 13

What medications can contribute to dizziness/falls?

Answer 13

1. sedative-hypnotics
2. antihypertensives
3. long-acting benzos
4. TCAs
5. antipsychotics
6. anticonvulsants

Question 14

What medications contribute to EPS in elderly?

Answer 14

1. typical antipsychotics
2. Metoclopramide

Question 15

What medications can contribute to mental status changes?

Answer 15

1. anticholinergics
2. benzos
3. skeletal muscle relaxants
4. TCAs
5. GI antispasmodics
6. antihistamines

Question 16

What does depression in the elderly put them at higher risk for?

Answer 16

1. dementia
2. decreased social function
3. decreased self-care

Question 17

How are elderly screened for depression?

Answer 17

Geriatric Depression Scale