Term
| EFFECTS OF AGGING ON MEDICATION |
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Definition
DRUGS ACT DIFERENTLY IN THE OLDER ADULTS, THEY TAKE MORE THAT ONE MEDICATION,
INCREASE RISK OF INTRATION AND ADVERSE REACTION, CLOSE SUPERVSION AND ADHERENCE TO SOUND PRINCIPLES OF SAFE DRUG USE ARE ESSENTIAL |
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Term
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Definition
MULTIPULE DRUGS USED BY OLDER ADULTS...INC USE W/AGE.
MOST COMMONLY USED DRUGS:
CARDIOVASCULAR
ANTIHYPERTENSIVES
ANALGESICS
ANTIARTHRITIC AGENTS
SEDATIVES
TRANQUILIZERS
LAXATIVES
ANTACIDS |
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Term
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Definition
AE: AFFECTS QUALITY OF LIFE, SOME DRUGS CAN INTERACT ADN CAUSE SERIOUS ADVERSE EFFECTS
CONFUSION
DIZZINESS
FALLS
FLUID / ELECTROLYTE IMBALANCE
MONITOR PTS. FOR DRUG-DRUG INTERACTION, DRUG-FOOD INTERACTION OR DRUG-HERB INT... |
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Term
| DRUG ABSORPTION & ALTERATIONS |
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Definition
AGE RELATED CHANGES- DECREASE ICF, INCREASE GASTRIC pH, DECREASE GASTRIC BLOOD FLOW AND MOTILITY, REDUCE CO AND CIRCULATION, & SLOW DRUG ABS.
ROUTE OF ADMIN.- IM, SQ, ORALLY, OR RECTALLY R NOT ABS. AS EFFICIENTLY AS DRUGS THAT R INHALED, APPLIED TROPICALLY OR IV.
CONCENTRATION AND SOLUBILITY - HIGH SOL. & IN HIGH CONC. AE ABS. W/ GREATER SPEED.
DISEASE & SYMP- CONDITIONS SUCH AS DM AND HYPOKALEMIA CAN INCREASE THE ABS. OF DRUGS, WHEREAS PAIN AND MUCOSAL EDEMA WILL SLOW ABS...
EXERCISE STIMULATE CIRCULATION & AIDS IN ABS.
PROPERLY USED HEAT AND MASSAGE INCREASE BLOOD FLOW AT THE ABS SITE...
PREVENTING FLUID VOL DEFICIT, HYPOTHERMIA, & HYPOTENTION IS BENEFICIAL IN FACILITATING ABS...
PREPARATIONS THAT NUTRALIZE GASTRIC SECRETIONS SHOULD BE AVOIDED IF LOW GASTRIC pH IN REQUIRED FOR DRUG ABS...
NURSES SHOULD MONITOR FOR INTERACTIONS THAT MAY AFFECT ABS...
USE MOSE EFFECTIVE ROUTE FOR ADMIN....
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Term
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Definition
changes in circulation, membrance permeability, body temp, and tissue structure can modify the process...
Adipose tissue increase compare to lean body mass in older persons..especially in women...so drugs stored in AT will have increase tissue conc. decrease plasma conc..and a longer duration in the body.
decrease CO can rise the plasma level of drugs while reducing their deposition in reservoirs...particularly apparent with water soluable drugs...
reduce serum albumin levels can be problematic if several protien-bound drugs are consumed and compete for the same protein molecule... the effectiveness of the drug will be threatened. (salicylate, warfarin for ex)
when monitoring blood level of meds, it is important to evaluate serum albumin level....b/c some drugs can cause toxicity if albumin levels are low. (phenytoin)
dehydration and hypoalbuminemia decrease drug distribution & result in higher drug levels in the plasma...lower dosage may be needed..
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Term
METABOLISM, DETOXIFICATION |
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Definition
Dehydration, hyperthermia, immobility and liver disease can DECREASE TEH METAB. OF DRUGS...drugs can accumulate to toxic levels and cause serious adverse reactions...
half-life of may of the drugs consumed by older adults warrants close evaluation of drug clearance...monitor cerium creatinine levels....
In advance age, there may be a reduced secreation of some enzymes, which interfere w/ the metabolism of drugs tha require enzymatic activity....
detoxification and conjugation of drugs may be reduced...so drugs stay in the blood longer
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Term
| LIVERS FUNCTION IN DETOXIFICATION & EXCRETION |
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Definition
carbs metablolize in the liver converts glucose into glycogen and release it into the bloodstream when needed...
Protein metabolism in the parenchymal cells of the liver is responsible for teh loss of the amine groups from amino acids, which aid in the formation of new plasma protins, like prothrombin and fibrinogen....
also help with conversion of some poisonous nitrogenous byproducts into nontoxic subs...such as vitamin B12...
formation of bile, breakdown fats through enzymatic action and remove subs like bilirubin from the blood...
WITH AGE liver decrease in size and function...hepatic blood flow declines by 45% bet age 25-65....affecting metablolism of some drugs |
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Term
| ALTERED BIOLOGIC/THERAPUTIC EFFECTS OF DRUGS |
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Definition
- INCREASE MYOCARDIAL SENSITIVITY TO ANESTHESIAS
- INCREASE CNS RECEPTOR SENSITIVITY TO NARCOTICS, ALCOHOL, & BROMIDES
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Term
RISK FOR ADVERSE REACTION |
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Definition
high in older people b/c age realated differences
s/s may vary
prolong time may be required ffor an AR to become apparent
AR to drug may be demonstrated even after the drug has been discontinued
AR can develop suddenly, even with a drug that has been used over a long period of time w/o probs.
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Term
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Definition
Nurses should ensure that drug-induced cognitive & behavioral probs are not treated w/addtional drugs...
Hypoglycemia
acidosis
fluid & electorlyte imbalancesj
temp elevations
increase intracranial pressure
reduce cerebral circulation...produce mental disturbances....behavioral dysf...
changes in mental status...
cognitive dysf... |
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Term
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Definition
renal sys---bodys excretion function..after systemic circulation, the drugs filter through the walls of glomerular cap....into the Bowman capsule....the drugs continue down the tubule and benefical subs reabsorbed into the bloodstream through proximal tubules and waste subs excreted through the urine flow... capillaries surrounding the tubules reabsorb the filtered blood and join to form the renal vein....
with aging....the reduced efficiency of body organs w/ aging affects the kineys....complicating drug excretion...nephron units are decrease in #, & many of the reamining ones can be nonfuntional....glomerular filteration rate & tubule reabsorption are reduced....decreasing cardiac function contributes to the reduce blood flow to the kidneys....drugs are not as quickly filtered from the bloodstream and are present in the body longer.....increase the risk for adverse drug reactions....toxicity....
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