Week 7 - Polypharmacy

Question 1

What percentage of Canadians seniors were prescribed 10+ medications?

Answer 1

25% (1/4)

Question 2

What is polypharmacy? (3)

Answer 2

• use of more medications that clinically indicated
• often associated with the chronic use of 5 or more medications
• a large number of medications, contraindicated, potentially inappropriate, duplicated, or unecessary

Question 3

What are adverse drug reactions (ADR)? (2)

Answer 3

• unwanted reactions to medications that can range in severity (not predictable)
• cause of iatrogenic mortality and morbidity for older adults

Question 4

How many times more likely are adults with 10-14 different drug classes hospitalized than those with 4 or fewer?

Answer 4

five times

Question 5

Which medication-induced symptoms are the most concerning for adverse drug reactions? (3)

Answer 5

• Medication induced delirium, falls, and decline in function

Question 6

What can change the older adult’s response to medications? (2)

Answer 6

• diet
• physiological changes

Question 7

Which medications increase the risk for geriatric syndromes, including falls and delirium?

Answer 7

anti-cholinergic medications

Question 8

Which drugs increase the risk for drug-induced delirium? In other words, which drugs are anti-cholinergics? (5)

Answer 8

• antidepressants
• antihistamines
• antiparkinsonian agents
• antipsychotics
• benzodiazepines

Question 9

Which criteria identifies medications that carry a higher than normal risk for adverse medication effect?

Answer 9

• Beer’s Criteria

Question 10

Beers List is used to reduce polypharmacy. What is the criteria? (2)

Answer 10

• medication’s are considered appropriate or not appropriate according to the patient’s condition
• identify potential inappropriate medication’s that may exacerbate the disease or syndrome, and those that should be used with caution

Question 11

What is anti-cholinergic syndrome? In other words, what causes it?

Answer 11

Occurs when a person takes too many medications that block acetylcholine

Question 12

What are the benefits to blocking acetylcholine? (3)

Answer 12

• promotes urinary continence
• reduce motion sickness
• reduce allergy symptoms

Question 13

what are the drawbacks to blocking acetylcholine?

Answer 13

• adverse medication affects when the amount of acetylcholine blocked inhibits normal body function

Question 14

examples of 2 medications that block acetylcholine?

Answer 14

antihistamines, antiemetics

Question 15

What happens if acetylcholine is blocked in terms of cognition? (4)

Answer 15

• cognitive impairment
• acceleration of neurogenerative process
• appearance of psychotic or confusional symptoms
• functional disturbances

Question 16

What happens if acetylcholine is blocked? In other words, what are the presenting symptoms? (6)

Answer 16

• dry mouth
• urinary retention
• constipation
• paralytic ileus
• increased HR
• blurred vision