Walden University MN 6034 Gerontology Class Study Guide

Walden University MN 6034 Gerontology Class Study Guide 75 yo w/ severe anxiety disorder which bzd would be the best & minimize risk of falling a) Alprazolam b) Lorazepam (short t1/2 & doesn’t go thru liver metabolism) c) Diazepam d) Midazolam (Versed) - surgical prophylaxis (DOA too short) BZDs for elderly - LOT: lorazepam, oxazepam, temazepam - Use short-acting BZDs - Diazepam very long - Lorazepam has half life of 12 hours - Midazolam used for surgical prophylaxis Osteoarthritis tx for 72 yo women w/pain of 3 out of 10 A) Naproxen (increases risk of GI bleeding; okay for 50s) B) Acetaminophen ( 1st choice for OA) C) Ultracet (tramadol & APAP) For pain: avoid NSAIDs & prefer opioids Tramadol (ultram) on Beers-lowers seizure threshold & shouldn’t be used in patients with CrCl 30 mL/min 82yo on levothyroxine 50 mcg daily for 2 months TSH = 9.2 ( NORM = 0.4-4.2) -- underactive thyroid (low) -- ANSWER: increase daily dose to 75mcg & recheck TSH in 8 wks - TSH & T4 have an inverse relationship Grandma not sleeping well, wants OTC med - HTN - Alzheimer’s Disease - Arthritis (Rheumatoid) o MEDS: ASA, donepezil (insomnia & GI effects:N/V/D) , APAP, HCTZ, Atenolol a) Tylenol PM (Benadryl component) à sedation b) OTC sleep agent c) See the doc Aricept taken at night but if sleep disturbances occur take in the AM Lower dose of ambien may be prescribed 2.5mg QHS Already on Tylenol so don’t want to give extra - 325mg q6h prn (MAX: 3250) Which GI meds lower seizure threshold, exacerbate PD sx & potentially cause restlessness/insomnia or drowsiness? a) Bismuth subsalicylate b) Cimetidine c) Lansoprazole d) Metoclopramide (Reglan) BEERS o blocks dopamine receptors → Extrapyramidal side effects, tardive dyskinesia o Taken 4x/day before meals o Avoid in elderly: makes you feel loopy