pharmacokinetics
decreased small bowel surface area, slowed gastric emptying, reduced gastric blood flow, reduced gastric acid production, swallowing difficulties, poor nutrition, dependence on feeding tubes is?
a. absorption
b. distribution
c. metabolism
d. excretion
a. absorption
increased or decreased permeability of the blood brain barrier (BBB)
increased
what is polypharmacy
use of more medications than is medically necessary (usually 5 or more)
decreased drug clearance results in increased drug levels and potential toxicity
a. absorption
b. distribution
c. metabolism
d. excretion
c. metabolism
what happens to the blood flow to the brain
blood flow is decreased to the brain
name some of the characteristics that increase the risk of drug administration problems
lack of coordinated care
recent discharge from hospital
self treatment
multiple diagnosis
sensory/physical changes w aging
cognitive impairment
increased body fat, increased drug storage, reduced elimination, and prolonged period of action, decreased total body effects water soluble drugs, decreased albumin leads to decreased protein binding which increases the free drug available which increases the risk of drug toxicity
distribution
fill in the blank
_____ number of receptor sites with aging
decreased
name the 4 physiological changes with aging
decreased amount of total body water
increased body fat
decreased kidney mass
decreased liver mass/size
decreased excretion with aging leads to prolonged....
half life and elevated drug levels in the body
teaching ideas:
what can we do to help prevent barriers of drug use by older adults?
eyeglasses and hearing aids
large print
review all drugs at EVERY appointment
advise patient to use ONE pharmacy
what does decreased kidney mass cause
decreased renal blood flow
decreased glomerular filtration rate (GFR)
decreased clearance of drugs excreted by the kidney
what is beers criteria
14 page document identifying a long list of medications
provides safety information on drug-drug interactions
aids in decision making for drug therapy choices in geriatric population
what are some barriers to effective drug use by older adults?
problems understanding
impaired memory
taking too many drugs at different times
childproof drug bottles
what does decreased liver mass/size cause
decreased clearance of drugs metabolized by the liver