ch38 geriatric patients

Physiologic changes of aging

include decreased CO and bloodflow, hepatic function and bloodflow, renal bloodflow, glomerular filtration, nephron function, gastric secretions, peristalsis, first pass effect, body water, kidney weight, lean body mass, serum albumin, and increased body fat

Factors influencing drug dosages in patients

factors influencing this are weight, body fat, lab results (ex. BUN, creatinine, protein in blood, liver enzymes, electrolytes), and current health conditions

Factors that influence drug absorption in older patients

slower gastric emptying, altered nutrition, and greater use of OTC medications are factors that can affect this in the elderly

Creatinine clearance

indicator of glomerular filtration rate

Creatinine clearance formula in mL/min

(140 – age) - (kg weight) / (72 * serum creatinine mg/dL)

Effects of polypharmacy

effects of practice include increased treatment cost, increased chances for drug interactions, possible liver dysfunction

Conditions that contribute to digitalis induced arrhythmias in the elderly

in the geriatric, coronary atherosclerosis, hypokalemia, hypomagnesemia, and hypoxemia all contribute to high incidence of this cardio condition

How half lives of many sedatives and hypnotics are affected by aging

in those who are 60-70, more than half of these drugs have their half-lives increase. Reduced elimination occurs due to impaired kidneys or liver. Elderly patients have varying sensitivities to these

Six important principles for treating older adults

Take drug histories carefully. Prescribe drugs only for specific and rational indications. Define the goal of drug therapy. Start with small doses, adjust slowly, and check blood levels. Know what other drugs patient is taking. Keep regimen as simple as possible