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Drug action depends on four factors ?
The absorption of medicines given IM may be affected by differences in _____, _____, and ______in patients who are bedridden.
muscle mass, blood flow to muscles, and muscle inactivity
_____ administration in geriatric patients is often difficult to predict due to ______ and ____ of the skin along with a decrease in _____, decreased ________, and __________.
Transdermal; drying and wrinkling of the skin; decrease in hair follicles, decreased cardiac output, and diminishing tissue perfusion.
Many tablets or capsules may need to be crushed due to a reduced ________ in geriatric patients, making chewing and swallowing more difficult.
Geriatrics patients often have a _____ gastric PH because of loss of acid-secreting cells. Drugs destroyed by gastric acid are more ______absorbed and have ____ serum concentrations because of the lack of acid destruction.
higher, readily, higher
Drugs that depend on an acidic environment for absorption are more _____ absorbed and have ____ serum concentrations.
readily ; higher
Geriatric patients have a ______ gastric emptying time, partly because of the reduced acid secretion. A slower gastric emptying time may allow the drug to stay in contact with the absorptive tissue _____, allowing increased absorption with a ____ serum concentration.
slower; longer; higher
The geriatric patients has ____ GI motility and intestinal blood flow. This has the potential for altered absorption of medications, as well as either constipation or diarrhea, depending on the medication.
____ refers to the ways in which drugs are transported by the circulating body fluids to the sites of action, metabolism, and excretion.
Distribution is dependent upon the following:
the amount of water in body, PH levels, amount of fat in tissue, protein binding, and cardiac output(blood flow)
Drug _____ is the process by which the body inactivates medications.
Drug metabolism is controlled by factors such as:
Diet, age, genes, and proper enzymes.
Enzyme systems, primarily in the _____, are the major pathway of drug metabolism.
Liver weight, the number of functioning hepatic cells, and hepatic blood flow ____ with age. This results in ___ metabolism of drugs in older adults.
Dosages usually must be ____ or the time interval between doses ____ to prevent accumulation of active medicine and potential toxicity.
reduced ; extended
Primary routes of drug excretion from the body are through the ____ into the ____ and the _____ to the ____.
renal tubules ; urine; GI tract into the feces.
As a person ages, important physiologic changes take place in the kidneys, including _____ renal blood flow, a loss of _____, and ____ tubular function and concentrating ability.
decreased, glomeruli, decreased
Renal function can be estimated in the geriatric patient by drawing a ______ level.
_______ the measurement of a drugs concentration in biologic fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response. Blood samples are usually drawn to measure how much of the medication is present in the blood to achieve therapeutic effectiveness.
Therapeutic drug monitoring
Complete a thorough ___, including use of nonprescription and herbal medicines, nutritional supplements, and alternative therapy.
A thorough ____ should be completed for the patient to determine the balance in patients diet.
When evaluating a new symptom in a geriatric patient, determine first if ______
it was induced by medications being taken.
When discontinuing drug therapy, ____ the dosage when appropriate to prevent symptoms that can occur from sudden discontinuation.
Geriatric patients may have difficulty with _____ large tablets or capsules.
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