Transcript Chapter 6 - Delmar Cengage Learning

Chapter 6
Drug Therapy for
Geriatric Clients
Drug Consumption
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Age ≥ 65 = increasing population growth
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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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Absorption
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Diminishes with increased age
GI concerns
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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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Distribution
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Water loss
Muscle loss
Fatty tissue increase
Protein binding: decreased capacity
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Metabolism
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General decline as age increases
Causes are obscure; possibly due to:
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Reduced blood flow to the liver
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Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
Excretion
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Measure creatinine function
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Blood flow to the kidneys reduced
Renal function is reduced
Loss of intact nephrons
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Drug Receptors
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Internal drug receptors may change
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Results in diminished or greater responses
Close monitoring is required
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Other Factors
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Memory loss
Sensory loss
Multiple health problems
Multiple medications at multiple times
Use of multiple pharmacies
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(continued)
Other Factors
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Economic factors
Lack of education
Communication problems
Cultural considerations
Diet therapy
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Implementation
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Oral medications
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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
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Use ventrogluteal site.
Avoid deltoid muscle.
Avoid vastus lateralis because of loss of
muscle mass.
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Storage
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Safe storage of medications
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Keep out of the reach of grandchildren and
other young children.
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Evaluation
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Evaluate
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Communication: Does client understand?
Drug action
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Promoting Health
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Prevent infections.
Improve nutrition.
Encourage exercise and activity.
Facilitate social interaction.
Promote restful sleep.
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