Pharmacology and the Older Adult

8/8/2019 Pharmacology and the Older Adult

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Pharmacology and the OlderAdultGeriatric Nursing


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Topics

Cultural Diversity & Medication Safety

Pharmacokinetics: Alteration in the OlderPersons

Polypharmacy

Alteration and Complementary Medicine

Promoting Adherence & Compliance Assessing Older Patients Appropriate Use of

Medication

Medication Management


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Cultural Diversity

Patients whose culture is taken into

considerationh

ave better outcomes th

an th

osewhose culture is not considered

A key strategy for achieving cultural competence

is to learn about different cultural and religiouspreferences, customs, and restrictions


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Heritage

Ethnicity

Nationality Religion

Culture

Characteristics to Be Considered


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Five Major Ethnic Groups


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European Americans

Christians

Less likely to rely on spirituality (God) and turn toscience

Turns to the government to take care of the elderly

Does not have close family ties

doers does not want to be a

burden to ot

hers

Retirement they lose their self-worth

Follows the advice ofhealth care providers thanother groups


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Top 5 Health Concerns

1. Smoking by pregnant women

2. Drug-induced deaths3. Deaths from poisoning

4. Deaths from melanoma

5. Deaths from chronic lower respiratory disease

before age 45


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African Americans

Most are Protestant, some are Muslim

More spiritual especially in health and wellness Close family ties

Does not trust authorities much

Distrustful of Medical personnel


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1. &

2. New cases of gonorrhea3. Congenital syphillis

4. New cases of AIDS

5. Deaths due to HIV infection


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Hispanic Americans

MostlyCatholics

Places a high value in family, religion, andcommunity

Will seekhomeopathic remedies with religiousartifacts before seeking health care

Illnesses are also due to their sins


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1. Congenital syphillis

2. New cases of tuberculosis3. New cases of AIDS

4. Exposure to particulate matter

5. Cirrhosis deaths


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Asian Americans

Earliest settlers are from China

Most are Budd

hism,

Confucianism,

Taoism

Basic concept: all things are composed ofopposing forces (yin-yang)

Should be balanced, if not, diseases manifest

Some elderly clients forgo life-sustainingtreatment because ofRen


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1. New cases of tuberculosis

2. C

ongenital syph

illis3. No Pap test among females older than 18

4. Exposure to particulate matter other than 18

5. Carbon Monoxide exposure


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Native American

Mostly Indians/Alaskan Americans

Naturalistic approac

htoh

ealth

and illness


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1. Fetal alcohol syndrome

2.

Smoking by pregnant women3. Alcohol-related motor vehicle deaths

4. Cirrhosis deaths

5. New cases of gonorrhes


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Ethnicity and Obesity

African American 35%

Hispanic 33%

European American 22%

Others 30%

African American & Hispanic : Poverty European American : Higher Income & LessEducation; or Excess in Living


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Pharmacokinetics

Time course by which the body absorbs,

distributes, metabolizes, and ex

cretes drugs How drugs move through the body and how

quickly this occurs


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Absorption

Movement of a drug from the site of

administration, across th

e biological barriers,into the plasma

Least affectedby age, although drugmovement decreases


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Distribution

Movement of a drug from the plasma into thecells

As people age, water declines and fat storesincrease Affects distribution phase of water-soluble & fat

soluble drugs

Hepatic & Renal mass, & hepatic & renal bloodflow decrease Hepatic metabolism of drugs is reduced Renal excretion is also decreased


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Pharmacodynamics

Time course a and effect of drugs on cellular and

organ function.

Is what drugs do when they are inside the body

Ex.

Benzodiazepines increased sedation Opiates increased analgesia and respiratory

suppression

Warfarin increased anticoagulant effect


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Polypharmacy

Prescription, administration, or use of manymedications than are clinically indicated in a

given patient


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Screening for Polypharmacy

Is the medication necessary?

Do t

he benefits outweig

hth

e risks? Is this the safest drug available?

Is the frequency of the medication prescribedproperly?

Is the medication prescribed in the mostappropriate dose, route, and/or form?


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Complementary & AlternativeMedicine (CAM) Is a group of diverse medical and health care

systems, practices, and products th

at are notpresently considered part of conventionalmedicine


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Classifications of CAM

1. Whole Medical Systems

2.

Mind-body medicine3. Biologically Based Practices

4. Manipulative and Body-based Practices

5. Energy Medicine


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Whole Medical Systems

Involves complete systems of theory and practice

th

ath

ave evolved independently from parallel toallopathic medicine

Examples:

Homeopathy

Naturopathic Medicine


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Homeopathy

By German physician Dr. Samuel Hahnemann

Natural law of

like cures like or

Principle ofSimilars

Homeopathic Theory: when a persons vitalforce or self-healing process is out of balance,

health problems will develop Goal: Stimulate the bodys own healing

responses to prevent or treat illness

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Pharmacology and the Older Adult