Lecture 20: Geratric Pharmacokinetics
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22 Terms
15-20%
What percent of population is considered geriatric?
over 25%
What percent of reported ADEs are from geriatric patients?
30-35%
What percent of health care dollars do geriatric patients consume?
gastric pH, gastric (splanchnic) blood flow, gastric emptying, absorptive surface area
What factors in absorption have decreased in geriatric patients?
villa atrophy & increased mucosal connective tissue
Why is absorptive surface area in geriatric patients decreased?
active transport mechanisms
What transport mechanisms are decreased in geriatric patients?
total body water
What decreases with age resulting in decreased Vd of polar, water soluble drugs
procainamide, quinidine, theophylline, warfarin
examples of hydrophilic drugs that need increased concentration
barbiturates, benzodiazepines, phenothiazines, steroids
examples of lipophilic drugs that have increased half-life
alpha-1-acid glycoprotein
highly variable and increased in elderly with multiple disease states
albumin
decreased in distribution due to displacement from binding sites in polypharmacy
decreased blood flow and perfusion to liver, kidney, and other tissues
What may decrease in elderly cardiac output cause?
hepatic blood flow, hepatic mass, number of functional hepatocytes
What factors in liver composition are decreased?
Lorazepam, Oxazepam, Temazepam
LOT benzodiazepines
functional number of neurons, kidney size, renal blood flow, renal tubular function, glomerular filtration rate
What factors decreased in renal tissue?
acyclovir, cephalosporins, penicillins, imimpenem
examples of antimicrobials that may cause seizures
aminoglycosides, vancomycin
examples of antimicrobials that may cause nephro- or ototoxicity
atenolol, captopril
examples of cardiovasculars that titrate to effect
digoxin
example of cardiovascular that may cause cardiac toxicity
cimetidine, nizatidine, famotidine
examples of H-2 Receptor Blockers that may cause ‘atypical’ AFRs
decereased baroreceptor response
Why can hemostasis increased risk of orthostatic hypotension?
calcium channel blockers, beta adrenergic modulators
examples of drugs with decreased sensitivity