Term
| age over which is generally considered elderly (AARP) |
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Definition
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Term
percentage of seniors taking 3 or more medications
...8 or more medications |
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Definition
3 or more = 76%
8 or more = 34% |
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Term
| Which elderly people should pharmacists focus on? |
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Definition
| The 40% of them who do not understand their medications well |
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Term
| common problems experienced by the elderly |
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Definition
- impaired vision/hearing
- incontinence
- constipation
- poor nutrition
- falls - impacts independence
- insomnia
- weakness/fatigue
- iatrogenesis (drug/tx related disease normally due to poly-pharmacy)
- poverty
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Term
| medications associated with increased risk of falls |
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Definition
- BENZODIAZEPINES
- sedatives/hypnotics
- neuroleptics/antipsychotics
- antidepressants
- opiods
- loop diuretics (orthostatic hypertension)
- alpha-blockers
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Term
| What are some changes in pharmacokinetics as one ages? |
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Definition
- decreased renal function
- decreased hepatic function
- increased ratio of body fat/muscle causing decreased clearing of lipophilic drugs
- decreased metabolism
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Term
| What is the Beers Criteria for? |
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Definition
| potentially inappropriate medications in older adults |
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Term
| What does the Beers Criteria do? |
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Definition
| examines use of individual agents and their risk for adverse effects in the elderly |
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Term
| What are the three classes of drugs that the Beers Criteria focuses on? |
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Definition
- anti-cholinergics
- sedatives/drugs with CNS effects
- GI toxic drugs
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Term
| Why should anti-cholinergics be avoided in the elderly? |
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Definition
affect balance which could lead to falls
& have a negative effect on cognitive function |
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Term
| Why should GI toxic drugs be avoided in the elderly? |
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Definition
| much more prone to GI ulcers and bleeding |
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Term
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Definition
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Term
| What are some of the attributes associated with successful aging? |
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Definition
- positive spirituality, absence of depression and cognitive impairment
- absence of nutritional deficits, diabetes, arthritis, and functional disability
- higher education which is associated with a higher level of functioning
- stable housing, physical activity, preventative health measures
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Term
| #1 risk factor for drug-related problems in the elderly |
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Definition
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Term
| in effective geriatric pharmacotherapy we want to... |
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Definition
effectively treat both acute and chronic conditions without causing HARM
and promote conservative prescribing |
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Term
| in order to promote conservative prescribing we want to minimize what? |
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Definition
- total number and nonessential meds
- use of drugs with high potential for adverse outcomes
- use of drugs with negative impact on cognitive and/or functional status
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Term
| In order to minimize negative impact on cognitive and/or functional status we want to focus on what? |
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Definition
- functional state instead of evidence-based medicine
- the benefit of individual medication against primary body functions
test used to test - timed get up and go test
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Term
| Gradual dosage reductions for CNS medications should be done after the patient has been stable for how long? in order to reduce what? |
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Definition
| decrease dose after 3-6 months to reduce adverse effects |
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Term
| when adding/removing medications from treatment for an elderly patient what should be done after ONE week and as needed? |
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Definition
| reassement of clinical, functional, and cognitive status |
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Term
Advanced Care Directive
(Patient Self-Determination Act) |
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Definition
- educate public about end of life (EOL) care refusal, etc.
- encourage use of ACDs to prevent uncertainty for care at EOL
- reduce cost of EOL tx
- includes: life-sustaining tx, do not resuscitate orders, withholding/withdrawing tx
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Term
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Definition
total care of terminally-ill patient with disease that is not responsive to curative tx
is focused on controlling symptoms to maintain QOL rather than disease management
includes hospice care (which is interdisciplinary palliative care) |
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Term
How to communicate with the elderly
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Definition
- avoid stereotyping
- engage the patient in decision making
- speak to patient (NOT the caregiver) when possible
- accomodate for physical barriers such as vision, hearing, and cognition
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Term
| strategies for communicating with elderly patients |
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Definition
- use simple, direct wording
- use slower pace
- repeat instructions
- allow ample time to respond
- give reasons for advice
- use visual aids when possible
- follow-up
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