Drug Therapy for Geriatric Clients Chapter 6. Copyright 2007 Thomson Delmar Learning, a division of...

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Transcript of Drug Therapy for Geriatric Clients Chapter 6. Copyright 2007 Thomson Delmar Learning, a division of...

Drug Therapy for Geriatric Clients

Chapter 6

Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

6 - 2

Drug Consumption

Age ≥ 65 = increasing population growth Elderly are estimated to consume

approximately 1/3 of all prescription drugs Estimate elderly use 3/4 of over-the-counter

drugs

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6 - 3

Absorption

Diminishes with increased age GI concerns

Reduced stomach acid (HCl) GI absorptive surface area is reduced Prolonged gastric emptying rate Blood flow to the intestines is reduced Reduced muscle tone in the stomach and

intestines

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6 - 4

Distribution

Water loss Muscle loss Fatty tissue increase Protein binding: decreased capacity

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Metabolism

General decline as age increases Causes are obscure; possibly due to:

Reduced blood flow to the liver

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6 - 6

Excretion

Measure creatinine function Blood flow to the kidneys reduced Renal function is reduced Loss of intact nephrons

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Drug Receptors

Internal drug receptors may change Results in diminished or greater responses Close monitoring is required

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6 - 8

Other Factors

Memory loss Sensory loss Multiple health problems Multiple medications at multiple times Use of multiple pharmacies

(continues)

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6 - 9

Other Factors

Economic factors Lack of education Communication problems Cultural considerations Diet therapy

(continued)

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6 - 10

Implementation

Oral medications Position for administration: high Fowler’s Speak clearly and slowly. Offer the most important medication first. Have plenty of liquid available. Do not rush the elderly client.

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Intramuscular Medications

Use ventrogluteal site. Avoid deltoid muscle. Avoid vastus lateralis because of loss of

muscle mass.

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Storage

Safe storage of medications Keep out of the reach of grandchildren and

other young children.

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6 - 13

Evaluation

Evaluate Communication: Does client understand? Drug action

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Promoting Health

Prevent infections. Improve nutrition. Encourage exercise and activity. Facilitate social interaction. Promote restful sleep.