Quiz on Gero - cognition and dementia, created by Bethany Carter on 03/24/2018.
15% of US population is >65 and 80% have at least one chronic condition.
Signs that a psych issue may have organic etiology:
Onset > 40 yrs
Symptoms occur during major illness
Altered mental state
Abnormal vital signs
Always remember to assess for safety: [blank_start]mobility[blank_end], [blank_start]fall risk[blank_end], [blank_start]driving[blank_end].
"meals on wheels" delivery
Drugs that can cause hallucinations or psychosis:
• Drugs that can cause agitation:
Neuroleptics and antibiotics
Benzodiazepines and ARBs
Bronchodilators and activating antidepressants
Drugs with extensive first pass effect may not be absorbed as well as those with phase II pathways in the elderly.
The following are which type of drugs?
Hydrophilic drugs that build up in the leaner elderly.
Lipophilic drugs that get increased in with increased adipose tissue.
Protein-bound drugs that are increased in the elderly.
What is an issue with Lithium in elderly?
They don't like it.
Hydrophilic drugs have decreased distribution with decreased total body water.
They are too demented for it to have any effect.
It can cause delirium.
In prescribing SSRI's to the elderly, consider that:
They may disguise organic conditions.
They are only indicated for <65 years old.
Decreased fat:muscle ratio can result in serotonin syndrome.
Decreased plasma protein results in increased unbound, active drug.
Increased renal clearance changes elimination of drugs in elderly.
Risks of benzos with elderly:
Greater risk of addiction
Common side effects of psychotropic drugs in elderly:
o General: [blank_start]Decreased CNS arousal[blank_end]
o Peripheral cholinergic blockade: [blank_start]Urination and constipation[blank_end]
o Central cholinergic blockade: [blank_start]Confusion and memory problems[blank_end]
o Alpha-adrenergic blockade and central pressor blockade: [blank_start]Orthostasis[blank_end]
o Dopamine blockade: [blank_start]Gait and movement[blank_end]
Decreased CNS arousal
Drooling and slurring words
Urination and constipation
Confusion and memory problems
Gait and movement
Auditory or visual hallucinations
Benzodiazepines should be tapered very slowly in elderly clients, 10% per month for chronic users (> 1 month usage).
Types of reversible dementias:
Normal pressure hydrocephalus
Alcoholic and vascular dementias are irreversible.