-
1. What physiological changes in ageing are important in determining how drugs are handled?
Show Answer
Model Answer: Decreased glomerular filtration rate so decreased excretion of some drugs.
Decreased hepatic blood flow and enzyme activity so increased concentration of some drugs.
Reduced muscle mass and total body water causing increased proportion of body fat which causes increased volume of distribution of lipid soluble drugs.
-
2. Why are adverse drug reactions (ADRs) more common in the elderly?
Show Answer
Model Answer: Polypharmacy, so there is an increased chance of drug‒drug interactions, and therefore increased chance of ADR with more medicines.
Pharmacodynamic changes so more sensitive to drug effects
-
3. Which groups of medicines should be used with particular caution in the elderly, if at all, and why?
Show Answer
Model Answer:
Hypnotics – increased sedation and side effects, leading to falls, delirium, postural hypotension.
Opioids – increased sensitivity to effects.
NSAIDs – increased risk of gastrointestinal bleeding and of renal impairment.
Antihypertensives – increased risk of postural hypotension.
Anticholinergics – increased side effects, particularly constipation, urinary retention and postural hypotension.
Nephrotoxic drugs – already physiological decrease in renal function with age, which may be made worse
