Therapeutics - Geriatrics 1

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Therapeutics - Geriatrics 1
2015-04-07 13:44:40
Therapeutics Geriatrics
Therapeutics - Geriatrics
Therapeutics - Geriatrics
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  1. Why should Benzos and Non-benzo hypnotics be avoided in geriatrics?
    Risk of cognitive impairment, delirium, falls, fractures and MVAs
  2. Why should Estrogens w/ or w/o progestins be avoided in geriatrics?
    Carcinogenic, lack of cardioprotection in older women
  3. Why should sliding scale insulin be avoided in geriatrics?
    High risk of Hypoglycemia
  4. Why should sulfonylureas be avoided in geriatrics?
    • Prolonged half-life
    • Severe prolonged hypoglycemia
  5. Why should Non-Cox selective NSAIDs be avoided in geriatrics?
    Increased risk of GI bleed
  6. Why should skeletal muscle relaxants be avoided in geriatrics?
    • Poorly tolerated
    • Anticholinergic
    • Sedative
    • Risk of Fracture
  7. What are the first generation Antihistamines?
    diphenhydramine (Benadryl), carbinoxamine (Clistin), clemastine (Tavist), chlorpheniramine (Chlor-Trimeton), and brompheniramine (Dimetane)
  8. What is the brand name for nitrofurantoin?
    Furadantin, Macrobid, Macrodantin
  9. What are the Alpha 1 blockers?
    • Ending: -osin
    • Doxazosin (Cardura), Prazosin (Minipress), Terazosin (Hytrin)
  10. What are the Alpha agonists:
    • clonidine
    • guanabenz
    • guanfacine
    • methyldopa
    • moxonidine
  11. What are the tertiary TCAs?
    • -tryptiline
    • -pramine
    • -pin
  12. What are the Non-Benzodiazapine Hypnotics?
    • Z drugs:
    • -clone
    • -plon
    • -pidem
  13. What drugs should be avoided in HF with geriatrics?
    • NSAIDs
    • COX-2 inhibitors
    • Non-dihydropyridine CCBs (only for systolic HF) (diltia/verap)
    • TZDs
    • Cilostazol
    • Dronadarone
  14. What drugs should be avoided in geriatrics with Syncope (loss of consciousness when standing up)?
    • ACHEIs
    • Peripheral alpha blockers
    • TCAs
    • Olanzapine
  15. What drugs should be avoided in epilepsy?
    • Bupropion
    • Clozapine
    • Olanzapine
    • Tramadol
  16. What drugs should be avoided in geriatrics with insomnia?
    • Oral decongestants
    • Stimulants
    • Theobromines
  17. What drugs should be avoided in geriatrics with Dementia?
    • Anticholinergics
    • Benzodiazapines
    • H2 Antagonists
    • Zolpidem
    • Antipsychotics
  18. What drugs should be avoided in geriatrics with CKD (Stages IV and V)?
    • NSAIDs
    • Triamterene
  19. What drugs can be use alternatively to Meperidine or pentazocine?
    • Morphine
    • Oxycodone
    • Fentanyl
    • Hydrocodone
  20. What drugs can be used instead of Glyburide or Chorpromamide?
    Glipizide or Glimeperide
  21. What drugs can be used alternatively to Diphenhydramine?
    Loratadine, Fexofenadine, Cetirizine
  22. What drugs are used alternatively to Amitryptiline or Doxepin?
  23. What drugs are used alternatively to NSAIDs (non-COX selective?
    APAP and Celecoxib
  24. What drugs can be used alternatively to Methyldopa, Resperine, Doxazosin or Clonidine?
    ACEIs, Diuretics or CCBs
  25. 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?
  26. 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?
  27. 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?
  28. 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)