University:
York University
Course:
CHEM 2550 | Pharmacology for Health Sciences
Academic year:

2022
Views:

265

Pages:

1
Author:

Niklas

Chp7 Pharm. + Geriatric Considerations Physiologic Changes Everything declines w/ age. liver + kidney function - drugs don't get cleared from body as quickly/efficiently ↑ risk for postural hypotension w/ antihypertensives (Caution w/ positions slowly) Total protein levels: Loss of protein → Less binding → more free drug = ↑ = ↑ R/f toxicity Excess bleeding w/ anticoagulants or antiplatelets Total body water (TBW) alters drug distribution (drug must dissolve in liquid before being distributed to cell) Geriatric Considerations: Pharmacokinetics Absorption: Slowing of GI means longer for drug to reach intestines Distribution: protein for binding, more free drug, more drug reach cell = ↑ R./P toxicity. Metabolism: liver function Excretion: & Kidney function. PHARMACODYNAMICS Loss of sensitivity of adrenergic receptors = ↑ response of drugs that act on alpha/beta receptors. Blunting of compensatory reflexes: leads to ↑ R/F orthostatic hypotension ↑ Permeability of BBB: Drug cross more easily = ↑ R/F CNS side effects. Older Adults: Drug dosing / Monitoring Polypharmacy-Taking 5 or more drugs daily, or more drugs than medically necessary. Why dangerous? incidence of geriatric syndromes: Common health conditions. They ↑ ADR's, mortality. Geriatric Syndromes: Cognitive impairment, falls, & functional status, urinary incontinence, pressure injury, delirium, Weight loss Risk factors + polypharmacy: Advanced age, female sex, mult HCP's, use of herbal therapies, OTC drugs, multi chronic diseases, hospitalizations, care transitions. How to ↓ polypharmacy: Use ONE pharmacy. Give pharmacist list of all drugs including OTC + Supplements. BEERS criteria list of potentially inappropriate drugs for elderly. Avoid use w/ caution, dosing adjustment. ADR's: polypharmacy, pharmacokinetics/dynamics ie. Adherence is a problem why? pg 53 table 7.2 ↑ ADR's + toxicity