15% of US population is >65 and 80% have at least one chronic condition.
Answer
True
False
Question 2
Question
Signs that a psych issue may have organic etiology:
Answer
Onset > 40 yrs
Symptoms occur during major illness
Altered mental state
Eye abnormalities
Speech disturbances
Psychosis
Gait disturbances
Abnormal vital signs
Question 3
Question
Always remember to assess for safety: [blank_start]mobility[blank_end], [blank_start]fall risk[blank_end], [blank_start]driving[blank_end].
Answer
diet
mobility
clean clothes
fall risk
bruising
urination
"meals on wheels" delivery
poor eyesight
driving
Question 4
Question
Drugs that can cause hallucinations or psychosis:
Answer
Levo-dopa
Procainamide
Estrogen
Steroids
ACE inhibitors
Question 5
Question
• Drugs that can cause agitation:
Answer
Neuroleptics and antibiotics
Benzodiazepines and ARBs
Bronchodilators and activating antidepressants
Question 6
Question
Drugs with extensive first pass effect may not be absorbed as well as those with phase II pathways in the elderly.
Answer
True
False
Question 7
Question
The following are which type of drugs?
• Amiodarone
• Diazempam
• Chlodiazepoxide
• Clonazepam
• Lidocaine
• Haloperidol
Answer
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.
Question 8
Question
What is an issue with Lithium in elderly?
Answer
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.
Question 9
Question
In prescribing SSRI's to the elderly, consider that:
Answer
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.
Question 10
Question
Increased renal clearance changes elimination of drugs in elderly.
Answer
True
False
Question 11
Question
Risks of benzos with elderly:
Answer
Delirium risk
Self-neglect risk
Dementia risk
Fall risk
Greater risk of addiction
Question 12
Question
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]
Answer
Decreased CNS arousal
Dementia
Drooling and slurring words
Urination and constipation
Prolonged QTc
Confusion and memory problems
Orthostasis
Increased HTN
Gait and movement
Auditory or visual hallucinations
Question 13
Question
Benzodiazepines should be tapered very slowly in elderly clients, 10% per month for chronic users (> 1 month usage).
Answer
True
False
Question 14
Question
Types of reversible dementias:
Answer
Thyroid disorders
B12 deficiency
Neurosyphilis
Normal pressure hydrocephalus
Depression
Question 15
Question
Alcoholic and vascular dementias are irreversible.