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The nurse is caring for an elderly patient. The laboratory
reports reveal decreased liver function. How does this
change impact the drug action?
1
Increased excretion
2
Reduced absorption
3
Reduced metabolism
,4
Increased first pass metabolism - ANSWER-Reduced
metabolism
Most drugs get metabolized in the liver. The decreased
liver function will lead to reduced metabolism of drugs. As
a result, drugs may not be available for therapeutics effect
or excretion may be reduced, causing drug toxicity.
Reduced liver function does not cause increased drug
excretion, as drug excretion take place through kidneys.
Liver impairment does not affect absorption, as it is a
function of the stomach and intestines. Impaired liver
function may decrease first pass metabolism.
,What does the nurse expect the primary health care
provider to prescribe to an older adult for insomnia?
A
Digoxin (Lanoxin)
B
Temazepam (Restoril)
C
Fluoxetine (Prozac)
D
Ketorolac (Toradol) - ANSWER-Temazepam (Restoril)
Temazepam (Restoril), an intermediate-acting
benzodiazepine, is biotransformed in the liver by
conjugation, and the principle metabolite is excreted in the
, urine. Therefore, the drug is prescribed for older adults.
Digoxin (Lanoxin) is a cardiac glycoside, not a hypnotic or
sleep-inducing drug. Fluoxetine (Prozac) is an
antidepressant. Ketorolac (Toradol) is an analgesic, which
is usually not prescribed to older adults because it causes
serious gastrointestinal toxicity.
While assessing the renal function in an elderly patient, a
nurse learns that the patient has reduced renal blood flow.
What is the impact of this age-related change on drug
action?
1) Decreased excretion