Geri pharma

Question 1

def. adverse drug event

Answer 1

an injury resulting from admin of a drug

Question 2

3 pharma factors influenced by ageing

Answer 2

1. pharmcokinteitc - how body handles drugs
2. pharmacodynamics - how drug affects body
3. drug-drug interactions

Question 3

4 parts of pharmacokinetics

Answer 3

1. absorbtion
2. dist.
3. meatbolism
4. elim

Question 4

what influences a drug’s bioavailality

Answer 4

• drug liberation
• gastic motlity
• drug properties
• drug transporters
• drug metabolsim

Question 5

2 gastic issues with age

Answer 5

1. higher gastic pH

2. less motility - slower to act

Question 6

how to change oral dosing with age

Answer 6

• no sig. need to change practices

Question 7

what are 3 effects of aging skine

Answer 7

• sun exposure
• less blood supply
• less water contenet

Question 8

3 ways vol. of dist changes with age and how it affects

Answer 8

1. more fat
   - longer half life of lipoohillic drugs - benzos
2. less water
   - larger conc. of lipo phillic drugs - digoxins
3. less protein binding cap

Question 9

2 phases of metabolism and how they change with age

Answer 9

1. • CYPs
     - decreases by 30%
2. conjugation
   - no chnage
   overall need to give a lower loading dose

Question 10

2 general ways drugs are removed

Answer 10

1. passive - renal

2. active - drug transporters

Question 11

how does renal function change

Answer 11

• less nephrons
• less blood flow
• less GFR
• need to be cautious about renal drugs

Question 12

3 renal drugs to be extra careful with

Answer 12

1. lithium
2. digoxin
3. sulfonourea

Question 13

ADME summary

Answer 13

A - less acid in stomach
D - langer half life and altered C
M - less liver metabolism
E - less kidney function

Question 14

2 main dynamic changes with age

Answer 14

1. drug-drug interaction

2. increased sens. to cog effects

Question 15

3 more sens to and 2 less sens. to

Answer 15

more
- sedatives
- opiods
- antichol
less
- BB
- A stims

Question 16

what is prob with benzos

Answer 16

CNS depression

• falls
• delirium
• less cog

Question 17

use zoplicone

Answer 17

• no, just as bad - no safe sleeping pill

Question 18

what is prescription cascade

Answer 18

giving drugs to Tx SE of previous drugs

Question 19

4 methods to help prevent ADE

Answer 19

1. computerized physician ordering
2. multidisc. support
3. patient educaiton
4. assessment of meds apporpriatness

Question 20

2 ways to assess appropriateness

Answer 20

1. beers criteria

2. med appropriatness index

Question 21

ris factors for not adhering

Answer 21

• polypharma
• cog issues
• funct. issues
• poor contact
• poor social supprt
• no assisstance with med. admin

Question 22

3 ways to improve adherence

Answer 22

1. med. dispensing aids
2. meds review
3. patient ed