Drug Therapy for Geriatric Clients Chapter 6 Drug Therapy for Geriatric Clients

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

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

Distribution Water loss Muscle loss Fatty tissue increase Protein binding: decreased capacity Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Metabolism General decline as age increases Causes are obscure; possibly due to: Reduced blood flow to the liver Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Excretion Measure creatinine function Blood flow to the kidneys reduced Renal function is reduced Loss of intact nephrons Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Drug Receptors Internal drug receptors may change Results in diminished or greater responses Close monitoring is required Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Other Factors Memory loss Sensory loss Multiple health problems Multiple medications at multiple times Use of multiple pharmacies (continues) Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Other Factors Economic factors Lack of education (continued) Other Factors Economic factors Lack of education Communication problems Cultural considerations Diet therapy Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

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

Intramuscular Medications Use ventrogluteal site. Avoid deltoid muscle. Avoid vastus lateralis because of loss of muscle mass. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Storage Safe storage of medications Keep out of the reach of grandchildren and other young children. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Evaluation Evaluate Communication: Does client understand? Drug action Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.

Promoting Health Prevent infections. Improve nutrition. Encourage exercise and activity. Facilitate social interaction. Promote restful sleep. Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.