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Drug Therapy for Geriatric Clients Chapter 6
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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
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
6 - 4
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.
6 - 5
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.
6 - 6
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.
6 - 7
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.
6 - 8
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.
6 - 9
Other Factors
Economic factors Lack of education Communication problems Cultural considerations Diet therapy
(continued)
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
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.
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
6 - 11
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.
6 - 12
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.
6 - 13
Evaluation
Evaluate Communication: Does client understand? Drug action
Copyright 2007 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved.
6 - 14
Promoting Health
Prevent infections. Improve nutrition. Encourage exercise and activity. Facilitate social interaction. Promote restful sleep.
