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Flashcards in Elderly Care Workshop Deck (26)
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1
Q

With elderly people, why must investigations into the true cause of any new symptoms be undertaken before prescribing a new medicine?

A

It is also important to understand that the elderly seem more sensitive to the side effects of any medicine. This may be due to the pharmacokinetic, pharmacodynamic or ageing changes that are occurring in this age group. When any new symptom presents, iatrogenic disease (symptoms that mimic a disease state but are actually an adverse effect of medicine(s)) must be excluded before prescribing a new item.

2
Q

What are the 10 key issues the influence the effectiveness of medication in the elderly?

A
  1. Preventable adverse reactions.
  2. Under-use of medicines.
  3. Not taking medicines.
  4. Wastage due to inequivalence.
  5. Hospital discharge - >changes to medicines.
  6. Poor two-way communication between sectors.
  7. Repeat prescribing systems
  8. Inadequate dosing instructions
  9. Access to GP surgery/pharmacy = difficult.
  10. under-use of carers.
3
Q

What are the 3 medicine related factors that increase the risk of a negative outcome in care of the elderly?

A

Taking >4 medicines.
Specific medicines: Warfarin, NSAIDs, diuretics, digoxin.
Recent discharge from hospital.

4
Q

What are the 3 social and personal factors that increase the risk of a negative outcome in care of the elderly?

A

Low level of home support.
Physical issues: poor vision, hearing and manual dexterity.
Mental state - confusion, disorientation, depression.

5
Q

What is true about most forms of dementia?

A

They cannot be cured but research is developing.

6
Q

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of

A

Dementia.

Donepezil
Rivastigmine
Galantamine

7
Q

What are three drugs that can alleviate the symptoms of dementia? what class are they?

A

Donepezil
Rivastigmine
Galantamine

AChEIs

8
Q

Dementia is a syndrome that is associated with an on-going decline of the brain and its abilities. These include:

A
Memory 
Thinking
Language
Understanding
Judgement
9
Q

How common is dementia?

A

570,000 people in England.

Occurs in people 65 and over.

10
Q

What are the 4 different types of dementia?

A

Alzheimers disease.
Vascular dementia.
Dementia with Lewy bodies.
Frontotemporal dementia.

11
Q

Rivastigmine/ Galantamine

A

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

12
Q

The type of dementia where small clumps of protein, known as plaques, begin to develop around brain cells disrupting the workings of the brain.

A

Alzheimers disease.

13
Q

The type of dementia where problems with blood circulation results in parts of the brain not receiving enough blood and oxygen.

A

Vascular dementia.

14
Q

Donepezil

A

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

15
Q

The type of dementia where abnormal structures, known as _____ bodies, develop inside the brain.

A

Lewy body dementia.

16
Q

The type of dementia where the frontal and temporal lobes being to shrink and develops in people under 65.

A

Frontotemporal dementia. Much rarer than other forms.

17
Q

AChEIs (Acetylcholinesterase inhibitors) are drugs that can temporarily alleviate the symptoms of Dementia

A

Rivastigmine
Galantamine
Donepezil

18
Q

What advice should be given to patients WRT if they have a fall at home?

A
  1. Try not to panic, stay calm.
  2. Do not get up quickly, roll onto your hands and knees and find a stable piece of furniture, such as a chair or bed, to support you as you slowly get up.
  3. Rest for a while before carrying on with your daily activities.
  4. If you are injured or cannot get up, call for help.
19
Q

What is Hospital 2 Home?

A

Hospital 2 Home was produced by a task group initiated by Care & Repair England, supported by the Department of Health and the Department for Communities and Local Government

20
Q

What are the 10 ways that medicines can cause falls?

A
  1. Sedation
  2. Impaired postural stability
  3. Hypotension
  4. Drug induced parkinsonism
  5. Visual impairment
  6. Hypoglycaemia
  7. Vestibular damage
  8. Hypothermia
  9. Confusion
  10. Dehydration.
21
Q

What drugs can cause falls by causing sedation/drowsiness?

A

Antidepressants
Antipsychotics
Parkinsons disease medication

22
Q

What drugs can cause falls by causing impaired postural stability?

A

Hypnotics
Sleep aids
Benzodiazepines.

23
Q

What drugs can cause falls by causing postural hypotension?

A

Diuretics

Antipsychotics

24
Q

What drug class can cause drug-induced parkinsonism?

A

Antipsychotics: increased risk of falls.

25
Q

What drugs can cause visual impairment and thus increase the risk of falls?

A

Antihistamines

Drugs for urinary incontinence

26
Q

What drugs can cause hypoglycaemia and thus an increased risk of falls?

A
B-blockers
CCB
Haloperidol
Diabetes medication
Insulin
Quinine