Pharmacokinetics Geriatrics 2

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  1. How does skin and hair change in older adults?
    Dryer, wrinkly, pigment changes, loss of dermal thickness, decrease in # of hair follicles and decrease in Melanocytes (grey hair), increased bruising
  2. What Genitourinary changes occur in the elderly?
    Atrophied vagina (due to low estrogen), Prostatic hypertrophy (due to androgenic changes), incontinence (due to the first two, not a normal part of aging)
  3. (True/False) Changes due to aging decrease the functional reserve capacity and ability to preserve homeostasis.
  4. (True/False) Elderly are less susceptible to decomposition in stressful situation.
    False, more
  5. Are most drugs actively or passively absorbed through the GI?
  6. Is passive absorption of elderly patients changed?
  7. What GI absorption parameters are changed in older adults?
    Decreased: Active transport, first pass metabolism and GI blood flow Increased: Gastric pH and emptying time
  8. Is there a significant change in quantity absorbed through the GI in the elderly?
  9. What Pharmacokinetics parameters are changed by an elderly person’s GI?
    Time to onset or peak may be delayed
  10. Morphine and Propranolol have high first pass metabolism, would first pass metabolism be higher or lower in older adults?
  11. Transdermal, SubQ and IM are changed in what ways in elderly patients?
    Atrophy of dermis and epidermis and reduced tissue perfusion cause decreased rate of transdermal drug absorption and decreased or variable IM and SQ absorption
  12. How is distribution of a water soluble drug changed in the Elderly?
    Decreased Vd and increased plasma concentration
  13. How is distribution of a lipid soluble drug changed in the Elderly?
    Increased Vd and Increased Half-life
  14. What drugs are water soluble?
    Ethanol, digoxin, lithium and theophylline
  15. What drugs are lipid soluble?
    Diazepam, Amiodarone and verapamil
  16. How does serum albumin change in older adults?
    Same or decreased
  17. Serum albumin binds what type of drugs?
    Acidic like warfarin and phenytoin
  18. What can effect serum albumin conc. in older adults?
    Diet, disease
  19. How is alpha1-acid glycoprotein changes with age?
  20. What is alpha1-acid glycoprotein a marker for?
  21. What type of drugs are most of concern when patients have reduced albumin?
    Highly protein bound
  22. What is the outcome of altered protein levels in elderly patients?
    Variable, increase or decrease in binding
  23. Does the liver increase or decrease with age?
    Decreases (20-30%)
  24. How do phase I reactions change in older adults?
  25. How do phase II reactions change in older adults?
  26. How does CYP activity change in older adults?
    Decreased or unchanged
  27. How does enzyme induction/inhibition change in older adults?
  28. Metabolism of high extraction ration drugs increase or decreases with age?
  29. What drugs have a high extraction ration?
    Propranolol, Morphine or Verapamil
  30. Is metabolism of the liver effected by race, sex, frailty?
    Yes, all
  31. What is the outcome of renal changes in older adults?
    Decreased clearance and increased half-life
  32. Is Serum creatinine clearance a reliable measure of age-related renal decline?
Card Set
Pharmacokinetics Geriatrics 2
Pharmacokinetics Geriatrics 2
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