Geriatric and Pediatric Pharmacology

Information about Geriatric and Pediatric Pharmacology

Published on July 14, 2014

Author: NischalTyagi

Source: authorstream.com

Content

PowerPoint Presentation: Nischal Tyagi M.Pharm (Pharmacology) Geriatric and Pediatric Pharmacology Introduction: The clinical responses to drug administration can be greatly influenced by the chronological age of the patient and by the relative maturity of the particular organ system that is being treated Age dependent changes in body functions alter the pharmacokinetic parameter that determine the ADME of each compound Introduction Objective : To discuss the some of the principles and the cautions that must be considered when treating these particular population So the health practitioner should be aware of the pharmacologic changes that may occur and how to deal with them while targeting this population Objective Special aspects of geriatric pharmacology: The changes generally observed are: Altered physiology Increased incidence of multiple diseases Nutritional deficiencies Improper drug compliance There may be lack of financial support Special aspects of geriatric pharmacology 13 I’s of geriatrics: Immobility Isolation Incontinence Infection Inanition Immunodeficiency Insomnia Impotence Impaired visual & auditory senses Impaction Intellectual loss Instability Iatrogenic responses 13 I’s of geriatrics PowerPoint Presentation: Physiological changes in elderly Decrease in total alveolar surface , respiratory muscle strength and maximal breathing capacity 3. Pulmonary System Decrease in total body water, plasma albumin,bone mass density and increase in body fat,alpha 1 acid gylcoprotein Body Composition Decrease in weight and size of brain , Cognition defects 2. Central Nervous system PowerPoint Presentation: Physiological changes in elderly Decrease in hepatic blood flow 6. Liver Decrease in myocardial senstivity to beta agonists and antagonists, cardiac output and increase in TPR 4.Cardiovascular System Increse in gastric pH and decrease in GIT blood flow, delayed gastric emptying 5. Gastrointestinal PowerPoint Presentation: Physiological changes in elderly Increase incidence of diabetes and thyriod disorder ; decrease in CMI 9.Endocrine and Immune system Decrease in glomerular filtration rate, renal blood flow and tubular secretion 7.Renal Prostatic hyperatrophy(M), vaginal atrophy and menopause(F), Incontinence 8. Gentiourinary Drugs to be avoided in elderly & their safer alternatives: Drugs to be avoided Reasons Safer alternatives Sedative – Hypnotics –Antianxiety Drugs (Diazepam, Barbiturates, Chlordiazepoxide ) Prolongation of half life due to decreased renal and hepatic function Oxazepam , Lorazepam,Aiprazolam have shorter half life Analgesics( opoids , NSAID’s) Elderly are very sensitive to their respiratory depressant effect of opoids , NSAIDs should be used with caution as they may cause GIT bleeding and renal damage Prefer codeine, meperidine , nimesulide , ibuprofen and COX-2 inhibitors Antidepressants(TCA) Avoided due to postural hypotension and anticholinergic side effects SSRIs are preffered Drugs to be avoided in elderly & their safer alternatives Drugs to be avoided in elderly & their safer alternatives: Drugs to be avoided Reasons Safer alternatives General anaesthetics (Halothane, Thiopental) Elderly are senstive totheir hepatotoxity Propofol , Isoflurane Drugs for Alzheimer’s ( Tacrine ) Tacrine has hepatotoxity Rivastigmine and galantamine preffered Antihypertensive drugs ( Propranolol , Methyldopa, Thiazide ) Half life and bioavailability of propranolol increases with age, methyldopa produces deep sedation, Thiazide cause electolyte imbalance Beta blocker, ACE inhibitor,CCBs , AT 1 blockers Cardiac Glycosides( Digoxin ) There is an increased arrythymogenic effect Reduce the dose Drugs to be avoided in elderly & their safer alternatives Drugs to be avoided in elderly & their safer alternatives: Drugs to be avoided Reasons Safer alternatives Antiarrythmic drugs( Quinidine , Xylocaine ) Clearance of quinidine is decreased in elderly and half life of xylocaine is increased Doses should be reduced Antianginal Drugs ( Isosorbide and verapamil ) Hypotensive effect and hypotensive effect diltiazem Drugs for respiratory disorders(Ephedrine , Theophylline ) Ephedrine causes rise in BP,tachycardia,urinary hesitancy, Half life of theophylline gets increased in elderly Prefer salbutamol , terbutaline , budesonide Antiemetic ( metoclopramide ) Metaclopramide is avoded due to its extrapyramidal side effects Domperidone , ondansetrone Drugs to be avoided in elderly & their safer alternatives Drugs to be avoided in elderly & their safer alternatives: Drugs to be avoided Reasons Safer alternatives Antibiotics( Penicillins , cephalosporins,fluoroquinolones , Nitrofurantoin ) Half life of these drugs is prolonged due to decline in renal function Tobramycin,Cefitriaxone , Cefoperazone Antidiabetics ( Chlorpropamide ) Half life is increased and may cause serious hypoglycaemic episodes Glipizide , Glicazide,metforminn Laxatives(Castor oil, Magnessium sulfate,liquid paraffin) Castor oil causes damage to intestinal mucosa and magnesium sulfate may cause hypermagnesia if renal function is imapired Bran, senna,bisacodyl Drugs to be avoided in elderly & their safer alternatives PowerPoint Presentation: The expense of drugs can be a major disincentive in economically week elderlies thus the prescriber must focus upon cheaper alternatives which can be improved by judicious use of the drugs by considrinf safer options Despite the benefits of drug therapy, the health related quality of life can be compromised due to drug related problems PowerPoint Presentation: Physiological changes in elderly 3 Templates 1 Templates 2 PowerPoint Presentation: Physiological changes in elderly 3 Templates 1 Templates 2 PowerPoint Presentation: This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text Your own footer Your Logo Your own sub headline Templates 1 2 3 4 5 6 7 PowerPoint Presentation: Your own footer Your Logo This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text. This is an example text. Go ahead and replace it with your own text. PowerPoint Presentation: Your own sub headline Templates Your own footer Your Logo This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it This is an example text. Go ahead and replace it ✓ ✓ ✓ ✓ ✓ ✓ ✓ 1 2 3 4 5 6 7 PowerPoint Presentation: THANK YOU

Related presentations


Other presentations created by NischalTyagi

Serotonin
14. 07. 2014
0 views

Serotonin

Antibiotics intreaction
14. 07. 2014
0 views

Antibiotics intreaction

APOPTOSIS ppt
14. 07. 2014
0 views

APOPTOSIS ppt