Term
| Do the elderly have an increased response to adrenergic agents? So if there stress response stays the same, will your serum catecholamine levels increase or decrease? |
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Definition
| No, there response is decreased, so if you are stressing these old farts out their serum catecholamine levels will increase |
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Term
| do the elderly have an increased resistance to insulin? how do they tolerate glucose loads? |
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Definition
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Term
| what are the blood sugar levels that you want to keep intraop in the elderly? postop? |
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Definition
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Term
| heat production __________, heat loss __________, and the hypothalmic temp regulating center is set at a _________ level in the elderly |
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Definition
| decreases, increases, lower |
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Term
| renal blood flow, mass, and overall function drcreases in the elderly. how does this effect their ability to manage sodium? what are they succeptible to? how are drugs effected? |
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Definition
| their kidneys have an impaired ability to dilute and concentrate urine, they are succeptible to dehydration or fliud overload (and ultimately renal failure), drug excretion by the kidneys is reduced (esp. NSAIDS) |
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Term
| what are the four keys to managing my old pts kidneys? |
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Definition
| fluid management, avoid (or use reduced doses)drugs that are eliminated from the kidneys, monitor lytes closely, monitor CVP and U/O closely |
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Term
| does the rate of biotransformation in the liver increase or decrease in old peops? |
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Definition
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Term
| Gastric ph _________, and gastric emptying _______ in the elderly |
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Definition
| lowers (more acidic), slows |
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Term
| what memory is most effected when we get old? |
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Definition
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Term
| what are the main neurotransmitters that have reduced synthesis in the elder population? |
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Definition
| dopamine, seratonin, GABA, and adrenergic |
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Term
| what leads to a prolonged conduction velocity and skeletal muscle atrophy in the elderly? |
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Definition
| degeneration of peripheral nerve cells |
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Term
| is MAC increased with age (more gass needed for the same effect) |
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Definition
| hell no, it is decreased in the old peops |
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Term
| Epidural behavior changes in the old people, how? |
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Definition
| a more cephelad spread, shorter duration, and shorter motor bolck |
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Term
| is my spinal going to last longer or shorter in the elderly? |
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Definition
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Term
| With beta blockers, what is my target BIS in the elderly? |
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Definition
| 55-60, 35-45 is associated with a higher mortality |
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Term
| what problems do my gas monitors present when i have an old pt on the table? why do i care? |
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Definition
| they assume the pt is 40y/o, they do not take into account other drugs that i gave (opioids and epidurals), and they underestimate brain concentration on emergence |
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