About this product Product Information Elderly Care Medicine Lecture Notes provides all the necessary information, within one short volume, for a sound introduction to the particular characteristics and needs of elderly patients. Presented in a user-friendly format, combining readability with high-quality illustrations, this eighth edition has been thoroughly revised to reflect advances in knowledge on how disease presents in elderly people, and changes in management practice, particularly regarding stroke, dementia, delirium, and cancer.
Lecture notes. Elderly care medicine / Claire Nicholl, K. Jane Wilson. - Version details - Trove
New for this edition, Elderly Care Medicine Lecture Notes also features: More treatment tables and boxes throughout for rapid access and revision Expansion of material on polypharmacy and prescribing Discussion of emotional support, counselling and spirituality Advice for doctors on breaking bad news and end-of-life care Consideration of ethical and legal issues A companion website at www.
Not only is this book a great starting point to support initial teaching on the topic, but it is also easy to dip in and out of for reference or revision at the end of a module, rotation or final exams. Whether you need to develop or refresh your knowledge of geriatrics, Elderly Care Medicine Lecture Notes presents need to know information for all those involved in treating elderly people.
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You may also like. Marie Claire Magazine Back Issues. This item doesn't belong on this page. A poor metabolizer needs less, a rapid metabolizer needs more. Whenever prescribing a new drug for an elderly patient, always check to see whether the drug inhibits or induces the CYP enzymes.
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These two have drug interaction because ciprofloxacin inhibits the same CYP that the Warfarin needs for metabolization. So the patient will end up with too much Warfarin in their system and will be at risk of bleeding. CoQ10, garlic, echinacea, ginkgo, ginseng, glucosamine, saw palmetto, st. Personalized Medicine A group of people with the same diagnosis and same prescription will break into four groups based on CYP genetics: — toxic, but beneficial — toxic but not beneficial — not toxic and not beneficial — not toxic and beneficial.
Example: SSRI antidepressant medication. Some will have side-effects.
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Example: Proton pump inhibitors Prilosec, Prevacid, Nexium 21 clinically relevant polymorphisms. Actually works better in Asian population because of genetics, than in whites and blacks. Example: Warfarin study found adjusting the dose based on genetic background, people have a better result. Example: Plavix box actually states some people, especially Asian, is nonfunctional and can have more cardiovascular problems and bleeding. The future will include testing of CYP genetic background so doctors can use that information for prescriptions that work.
With age, there is: 1 Decrease in lean body mass 2 Total body water 3 Increase in body fat. Digoxin, distributes and binds to muscles, will reduce Vd due to reduced muscle mass. Example: alcohol consumption is the same over the decades, but as water reduces in the body the effect of alcohol on the body will begin to cause hangovers. If you have glasses of water with the wine, you will compensate and reduce chance of hangover. Two patients with the same genetic background, one years-old, one years-old, both given 1mg of Ativan, the year-old will be fine, but the year-old will be very drowsy.
The less bound a drug is, the more efficiently it can traverse cell membranes or diffuse.
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Albumin protein binds to drugs and takes it to its effective destination in the body. Older people produce less albumin than younger people. Pharmacodynamics: response to medication Describes how drugs exert their effect at the site of action and the time course and intensity of pharmacological effect. You need a receptor in the destination organ. What can we do?? You can have a consult with your pharmacist about drug interaction potential if you get all your prescriptions filled at the same pharmacy.
Sometimes pharmacists will call doctors and question their prescription due to drug interaction.
Grapefruit-drug interaction? The pharmacy insert will say not to take certain medications with the grapefruit at the same time. If your medication is inhibited by grapefruit and you always have grapefruit with breakfast, you can take your medication with lunch. As long as there is some time between, you should be fine. Current state of personalized CYP mapping? There are some companies doing it, but it is not covered by insurance.
Its just a sample from inside your cheek. Congress has a act that nobody can use genetic info against you, including insurance companies to raise your rates. If you kept good records of your interactions of drugs, can you ascertain from that which CYP system your genetics are? You would need to have the doctor and pharmacist on board to document everything. Takes Gabapentin and pain medication. Pharmacy insert says the pain medication will reduce the effect of gabapentin. Will gabapentin or lyrica cause your blood to become thinner? Yes, those and others reduce platelet count, which also increases your risk of bleeding.
Pharmacist working on Aleve experienced the phenomenon of this talk with animal testing before they understood the genetics of this. If the person is having mental or physical changes you can suspect a drug interaction. Even medications they have been taking for awhile can begin to cause problems because of the changes of aging. First thing needs to be a review of the medications list, including OTC and herbals. For better pain control, Norco pain medications should increase the morphine part once the Tylenol part is maxed-out IF you can tolerate an increased morphine portion.
They include: Ask your doctor: — Is this medication necessary? Drugs and the Elderly Good or Bad?? Successful Pharmacotherapy? Nortriptyline needs to become inactive in the liver.
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