Therapeutics - Geriatrics 1
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Why should Benzos and Non-benzo hypnotics be avoided in geriatrics?
Risk of cognitive impairment, delirium, falls, fractures and MVAs
Why should Estrogens w/ or w/o progestins be avoided in geriatrics?
Carcinogenic, lack of cardioprotection in older women
Why should sliding scale insulin be avoided in geriatrics?
High risk of Hypoglycemia
Why should sulfonylureas be avoided in geriatrics?
- Prolonged half-life
- Severe prolonged hypoglycemia
Why should Non-Cox selective NSAIDs be avoided in geriatrics?
Increased risk of GI bleed
Why should skeletal muscle relaxants be avoided in geriatrics?
- Poorly tolerated
- Risk of Fracture
What are the first generation Antihistamines?
diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist), chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane)
What is the brand name for nitrofurantoin?
Furadantin, Macrobid, Macrodantin
What are the Alpha 1 blockers?
- Ending: -osin
- Doxazosin (Cardura), Prazosin (Minipress), Terazosin (Hytrin)
What are the Alpha agonists:
What are the tertiary TCAs?
What are the Non-Benzodiazapine Hypnotics?
- Z drugs:
What drugs should be avoided in HF with geriatrics?
- COX-2 inhibitors
- Non-dihydropyridine CCBs (only for systolic HF) (diltia/verap)
What drugs should be avoided in geriatrics with Syncope (loss of consciousness when standing up)?
- Peripheral alpha blockers
What drugs should be avoided in epilepsy?
What drugs should be avoided in geriatrics with insomnia?
- Oral decongestants
What drugs should be avoided in geriatrics with Dementia?
- H2 Antagonists
What drugs should be avoided in geriatrics with CKD (Stages IV and V)?
What drugs can be use alternatively to Meperidine or pentazocine?
What drugs can be used instead of Glyburide or Chorpromamide?
Glipizide or Glimeperide
What drugs can be used alternatively to Diphenhydramine?
Loratadine, Fexofenadine, Cetirizine
What drugs are used alternatively to Amitryptiline or Doxepin?
What drugs are used alternatively to NSAIDs (non-COX selective?
APAP and Celecoxib
What drugs can be used alternatively to Methyldopa, Resperine, Doxazosin or Clonidine?
ACEIs, Diuretics or CCBs
What three questions should you ask to tell if a medication is unnecessary?
- Is there an indication for the medication?
- Is the medication effective for the condition?
- Is the dosage correct?
What questions might you ask to evaluate medication adherence?
- What difficulty do you have taking your medications?
- What types of bottles or packages are difficult for you to open?
- How would you describe your eyesight and hearing?
- What medications did you take yesterday, when did you take them and how many did you take each time?
- How often have you taken medication X in the last week?
- Why are you taking medication X?
What questions should you ask to assess and monitor drug therapy?
- Does drug match problem list?
- Is drug effective?
- Benefits outweigh risks?
- Is there therapeutic duplication?
What patients should you target for medication evaluation?
- Insulin, warfarin, digoxin
- Recent hospitalization
- History of an adverse drug reaction
- History of a fall
- Advanced age (85 or older)
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