Older Adult Pharmacology Quiz

Older Adult Pharmacology

• Older adults are more sensitive to drugs compared to younger adults.
• They are more likely to have multiple chronic illnesses requiring multiple medications daily.
• The goal of treatment is to reduce symptoms and improve quality of life.
• Treatment should be individualized for each patient and monitored closely for both desired and adverse responses.

Adverse Drug Reactions (ADRs)

• Older adults are at a higher risk for ADRs.
• ADRs can lead to hospital admissions, injuries, and harm.
• Symptoms in older adults often don't present with specific characteristics.

Common Causes of ADRs in Older Adults

• Altered pharmacokinetics due to age-related changes.
• Drug-disease interactions.
• Polypharmacy (taking multiple medications).
• Medication mismanagement.

Beers Criteria

• Created by Dr. Beers in 1991 with ongoing updates.
• Includes medication classes that should be avoided or used with caution in older adults.
• Aims to reduce the risk of adverse drug events in older adults.

Pharmacokinetic Changes in Older Adults

• Absorption:
  • Delayed gastric emptying leading to prolonged absorption time.
  • Increased gastric pH (alkaline), which slows down the absorption of acid drugs.
  • Decreased blood flow to the gastrointestinal tract.
• Distribution:
  • Increased body fat percentage.
  • Decreased lean muscle mass percentage.
  • Decreased total body water.
  • Reduced serum albumin levels.
• Metabolism:
  • Hepatic metabolism declines with age.
  • Reduced hepatic blood flow, liver mass, and enzyme activity.
  • Increased drug half-life resulting in prolonged drug effects.
• Excretion:
  • Decreased renal function, leading to slower drug excretion.
  • Higher risk of drug accumulation and toxicity.

Protein Binding

• Drugs bind to proteins in the blood, mainly albumin.
• Reduced serum albumin levels in older adults lead to decreased drug binding and increased free drug levels.
• Increased free drug levels can result in higher drug efficacy and a greater risk of side effects.

Medication Nonadherence

• Cost and access to medication.
• Side effects from medication.
• Lack of perceived need for the medication.
• Complex medication regimens.

Promoting Medication Adherence

• Clear, concise verbal and written instructions.
• Simplified drug regimens.
• Clearly labeled and easy-to-open containers.
• Daily reminders.
• Patient education on their medications.
• Support system for medication adherence.
• Regular monitoring of clinical response and plasma drug levels.
• Monitoring for drug-drug interactions.
• Access to cost-effective generic medications when possible.
• Home delivery options for medication.

Test your knowledge on pharmacology specific to older adults. This quiz covers their unique sensitivities to drugs, the risks of adverse drug reactions (ADRs), and the importance of individualized treatment. Familiarize yourself with the Beers Criteria and understand the implications of polypharmacy.