Chapter 13 Pharm
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1
Why are older adults at higher risk for adverse effects?
high perscription drug use in the older adult population
2
What is the goal of treatment?
reduce symptoms and improve quality of life
3
Absorption
altered GI absorption is not a major factor in drug sensitvity
% of oral dose that is absorbed does not change with age
rate of absorption may slow with age
% of oral dose that is absorbed does not change with age
rate of absorption may slow with age
4
Distribution
increased % of body fat-storage depot for lipid soluble drugs
decrease % of lean body mass
decrease total body water
reduced concentration of serum albumin
decrease % of lean body mass
decrease total body water
reduced concentration of serum albumin
5
Metabolism
Hepatic metabolism declines with age
reduced hepatic blood flow, reduced liver mass, and decreased hepatic enzymes
half life may increase
reduced hepatic blood flow, reduced liver mass, and decreased hepatic enzymes
half life may increase
6
Excretion **important**
renal function progressive decline
drug accumulation due to reduced renal excretion is most important cause of adverse drug reactions
drug accumulation due to reduced renal excretion is most important cause of adverse drug reactions
7
How should renal function be assessed? **important**
use creatinine clearance rather than serum creatinine to assess
8
Adverse Drug Reactions (ADRs)
7 times more likely in the elderly
account for 16% of hospital admissions
50% of medication-related deaths
dizziness and cognitive impairment are most common
account for 16% of hospital admissions
50% of medication-related deaths
dizziness and cognitive impairment are most common
9
What should you monitor to reduce ADRs? **important**
monitor the pt response and plasma drug levels
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