Pharmacokinetics
Decreased gastric mobility, blood flow, swallowing difficulties as well as poor nutrition can affect this
What is ABSORPTION?
Pharmacodynamic response may be altered because of lack of this.
What is AFFINITY TO RECEPTOR SITES?
Use of these drugs can result in electrolyte imbalances leading to increased falls and delirium.
What are diuretics?
These medications have adverse risk that exceeds their health benefits when safer or equally effective alternatives are available.
What are Potentially inappropriate medications (PIMs)?
This change in blood pressure upon standing indicates orthostatic hypotension.
What is > 20 mmHg drop in systolic blood pressure?
Loss of these binding sites causes increased circulation of free drugs and increased chance for adverse drug reaction.
What are PROTEIN BINDING SITES?
Decreased number of and affinity for receptor sites requires this change to drug dosing.
What is DECREASED DRUG DOSE?
Clearance of this drug is reduced by up to 30% with increased age, resulting in prolonged drug effect
What is midazolam?
Use of these drugs is listed in Beers Criteria because of association with the risk of Clostridium difficile infections and increased probability of bone loss and fractures
What are proton pump inhibitors?
One-third of all U.S. elderly and up to 90% of elderly in nursing homes are associated with this. Effects of which can be adverse drug reactions, drug–drug interactions, non-adherence, falls, delirium and increased healthcare costs
What is polypharmacy?
This organ is fundamental in drug metabolism, loses enzyme function as well as size with aging.
What is the LIVER?
This loss of compensatory response to physiologic change can occur when vasodilators are used.
What is ORTHOSTATIC HYPOTENSION?
Haloperidol, quetiapine, erythromycin, methadone, dofetilide, citalopram, and ziprasidone can cause this common side effect:
What is prolonged QT interval?
This group is considered a special population and are mostly excluded from randomized controlled clinical trials.
Who are the elderly?
Poor vision, cognitive decline leading to forgetting of medication, and polypharmacy can all lead to this.
What is drug non-adherence?
A decrease in this results in drug accumulation and potential drug toxicity.
What is RENAL FUNCTION?
The Central Nervous System of older adults is approximately 30% more sensitive to this medication than younger patients, which has been reported for both induction doses and infusions.
What is propofol?
Over the counter drugs Ginger, Ginkgo, Garlic, Ginseng, and Green tea are herbs that share this side effect.
What is increased risk of bleeding?
This organization assumed responsibility of regularly updating and maintaining Beers criteria in 2012.
Who is the American Geriatric Society (AGS) ?
This intervention can reduce risk of elderly altering their dose or intake of medication to avoid adverse events; for instance not taking diuretics when going out.
What is a once-daily drug regimen?
This action during Phase II of biotransformation of drugs is not affected by older age, liver disease or drug interaction.
What is HEPATIC CONJUGATION?
Due to pharmacodynamic changes, titration of these drugs in the elderly should proceed carefully, with significantly reduced doses (25%–50%), longer redosing intervals, and avoidance of drugs with toxic metabolites.
What are opioids?
These are two classes of drugs associated with increased delirium when given to elderly surgical patients.
What are opioids, hypnotics, antihistamines, anticholinergics? (any 2 of these)
This drug should be avoided specifically by elderly patients with delirium
What is clonazepam?
This philosophy should be followed when starting elderly patients on new medications.
What is "start low, go slow"?