Geriatric syndromes

Home > Flashcards > Print Preview

The flashcards below were created by user giddyupp on FreezingBlue Flashcards. What would you like to do?

  1. What are the age related changes in physiology that affect pharmacokinetics?
    • Body composition:
    • decreased body water = decreased Vd H2O soluble
    • increased body fat = increased Vd fat soluble
    • GI:
    • increased gastric pH = decreased absorption of basic drugs
    • delayed gastric emptying
    • slowed intestinal transit
    • Liver:
    • decreased size
    • decreased hepatic blood flow
    • decreased clearance, increased half-life
    • Renal:
    • decreased GFR
    • decreased renal blood flow
    • decreased tubular secretory function
    • decreased clearance, increased half-life
  2. What are the types of urinary incontinence?
    • Urethral underactivity (stress urinary incontinence)
    • Bladder overactivity (Urge urinary incontinence)
    • Urethral overactivity and/or bladder underactivity (overflow incontinence)
    • Mixed incontinence (stress and urge incontinence combination)
  3. What are the sx of urethral underactivity (stress urinary incontinence)?
    • leakage of small amounts of urine during exertional activities
    • Frequency and urgency may be present
    • mostly WOMEN
  4. What are the sx of bladder overactivity (urge incontinence)?
    • urinary frequency (>8 times/d)
    • with or without urgency
    • nocturia and/or nocturnal enuresis
    • loss of larger urine volumes than stress incontinence
  5. What are the sx of overflow incontinence?
    • straining to void
    • dribbling
    • frequency
    • urgency
    • BPH
    • mostly MEN
  6. What drugs are used for stress incontinence?
    • Duloxetine (DOC)
    • alpha-Adrenergic agonists (pseudoephedrine)(2nd line)
    • Topical estrogen (pts with urethritis or vaginitis)
    • Imipramine
  7. What drugs are used for urge incontinence?
    • Anticholinergics/antispasmodics (oxybutunin or tolterodine are DOC)
    • TCAs (for depressed pts)
    • topical estrogens (pts with urethritis or vaginitis)
  8. What drugs are used for overflow incontinence?
    • alpha-1 blockers
    • 5-alpah reductase inhibitors
  9. What is the MOA of anticholinergics/antispasmodics in urinary incontinence?
    nonselective muscarinic antagonism
  10. What are the SE of anticholinergics/antispasmodics?
    • dry mouth
    • blurred vision
    • constipation
    • tachycardia
    • urinary retention
    • dizziness
    • confusion
    • cognitive dysfunction
    • sedation
    • erythema (patch)
    • pruritis (patch)
  11. Which anticholinergic formulation causes the most SE?
    immediate release
  12. Which anticholinergic formulations cause the least SE?
    • extended release
    • transdermal patch
  13. What is the MOA of alpha-1 blockers in BPH or overflow incontinence?
    • bladder neck and prostate smooth muscle relaxation
    • peripheral smooth muscle relaxation
  14. What are the SE of alpha-1 blockers?
    • first-dose syncope
    • OH
    • dizziness
    • Intraoperative floppy iris syndrome (IFIS)
  15. When are alpha-1 blockers used for BPH or overflow incontinence?
    monotherapy for moderate-severe disease with small gland and/or low PSA < 1.5ng/mL
  16. What is the MOA of alpha-1a blockers in BPH or overflow incontinence?
    selective for prostate receptors
  17. What are the SE of alpha-1a blockers?
    • ejaculatory dysfunction
    • sulfa allergy (tamsulosin)
    • priapism (tamsulosin)
  18. What is the MOA of 5-alpha reductase inhibitors in BPH or overflow incontinence?
    Inhibits conversion of testosterone to DHT, preventing prostatic growth
  19. What are the SE of 5-alpha reductase inhibitors?
    • sexual dysfunction
    • gynecomastia
    • decreases PSA
    • Pregnancy category X - don't handle
  20. When are 5-alpha reductase inhibitors used in BPH or overflow incontinence?
    • Moderate-severe disease
    • large gland > 40g and/or high PSA >1.5ng/mL)

Card Set Information

Geriatric syndromes
2011-03-25 07:15:56
Geriatric syndromes PHPR524 Test5

Geriatric syndromes
Show Answers:

What would you like to do?

Home > Flashcards > Print Preview