Term
| Leading causes of death for persons 65+ |
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Definition
| 1. Heart Disease 2. Malignant neoplasm 3. Cerebrovascular Disease |
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Term
| Sensory Impairment: Vision |
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Definition
| Risk factors: ocular diseases, age-related physiologic changes |
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Term
| Sensory Impairment: Hearing |
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Definition
| Presbycusis: most common pattern of hearing loss |
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Term
| Eating, bathing, toileting, grooming, dressing, etc. - measures ability to be independent |
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Definition
| Activities of Daily Living (ADLs) |
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Term
| Taking meds, housework, shopping, managing money, food prep, etc. - requires coordination |
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Definition
| Instrumental Activities of Daily Living (IADLs) |
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Term
| What percent of prescriptions and OTCs do old people consume? |
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Definition
| 30% of all prescriptions and 40% of OTCs |
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Term
| What percent of older adults experience adverse drug reactions (ADRs)? |
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Definition
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Term
| What changes in Absorption occur during aging? |
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Definition
| Decrease in active transport. Decrease in first pass effect. Increased gastric pH. |
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Term
| What clinical effects are observed in aging with Absorption? |
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Definition
| Decreased bioavailability of some drugs requiring active transport. Increased bioavailability for some drugs that undergo extensive first-pass hepatic/gut wall metabolism |
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Term
| What changes occur in aging for Distribution? |
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Definition
| Decrease in total body water. Increase in adipose tissue. Decrease in serum albumin. Increase in alpha-1-acid glycoprotein |
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Term
| What changes occur in Metabolism during aging? |
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Definition
| Decrease in hepatic mass. Decrease in hepatic blood flow |
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Term
| What clinical effects occur during aging for Metabolism? |
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Definition
| Decreased metabolism and increased half-lives of oxidatively-metabolized drugs. |
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Term
| What are changes seen in Excretion during Aging? |
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Definition
| Decreased renal blood flow. Decreased renal mass. Decreased GFR. Decreased tubular secretion |
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Term
| What are clinical effects of aging for Excretion? |
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Definition
| Decreased clearance and increased half-lives of some renally-eliminated drugs |
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Term
| What does the Cockroft Gault Equation measure? |
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Definition
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Term
| What are some pharmacodynamic changes that occur during Aging? |
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Definition
| changes in receptor #s, changes in receptor affinity, and age-related impairment of homeostatic mechanisms |
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Term
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Definition
| concomitant use of multiple drugs or administration of more medications than are clinically indicated |
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Term
| Risk factors for inappropriate polypharmacy |
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Definition
| use of multiple pharmacies and/or physicians |
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Term
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Definition
| when a prescriber writes a prescription to counterract the symptoms of a "new" chronic condition when it really is an adverse drug reaction (ADR) |
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Term
| When can inappropriate polypharmacy be caused by patients? |
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Definition
| When patients: expect a prescription for a particular complaint; borrow medications from family for different reasons; they use medications saved from previous therapies; or are confused by generic & brand name medications |
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Term
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Definition
| omission of drug therapy that is indicated for treatment or prevention of a disease or condition |
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Term
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Definition
| extent to which a patient's or caregiver's medication administration behavior coincides with medical advice |
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Term
| Unintential Non-Adherence |
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Definition
| forgetfullness, knowledge deficits, functional deficits |
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Term
| Intentional Non-Adherence |
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Definition
| Patient determines Rx is not needed; Pt feels presence of some adverse effects; Pt belief that more (or different) medication is needed |
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Term
| Factors that Impact Medication Adherence |
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Definition
| 1. Social/Economic factors (functional health literacy, income, med costs, insurance coverage); 2. Therapy related (complexity of med regimen, lack of immediate benefit, interference); 3. Patient-related (physical & psychological/behavioral); 4. Health System Related (quality of communication, lack of continuity of care, poor access, etc.) |
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Term
| Inappropriate Prescribing |
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Definition
| prescribing medications outside the bounds of accepted medical standards (risks outweighs potential benefits) |
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Term
| Barriers when Taking Medication Histories of Geriatric Patients |
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Definition
| communication, underreporting, lack of medical records, multiple diseases & medications |
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Term
| Ideas for Accurate & Thorough Medication History Taking in Geriatrics |
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Definition
| 1. ask by category of product; 2. ask by a review of symptoms; 3. ask about any as needed medication or supplement use; 4. ask patient to bring in all medications and supplements to visit |
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Term
| Medication Appropriateness Index (MAI) |
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Definition
| 10 questions that assess the appropriateness of each medication that a geriatric patient is using; it DOES NOT assess medication UNDERUSE!!! |
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Term
| What are 4 things to consider when recommending medications later in life? |
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Definition
| 1. remaining life expectancy, 2. time until benefit; 3. goals of care; 4. treatment targets |
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Term
| Roles of Pharmacist in Geriatric Counseling |
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Definition
| Provide verbal & written educational materials, observe medication administration, assist in selecting OTCs, provide up-to-date med list, recommend adherence aids |
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