CORRECT ANSWERS (VERIFIED ANSWERS ) A GRADE.
List the 3 best ssri's to give the older adult due to lack of anticholinergic
properties citalopram escitalopram sertraline which SSRI's should NOT be
given to older adults due to their anticholinergic properties and drug-drug
interactions?
fluoxetine paroxetine-ANSWER.
which of the TCA's should you absolutely avoid in the older
adult?
Amitriptyline -ANSWER
What are two antibiotics that can cause torsade de pointes particularly in
women?
Clarithromycin erythromycin
–ANSWER.
Remember that all macrolides can cause this including azithromycin can
cause an increase in the q-t interval which leads to v-tach or other rhythm
disturbances why should you NEVER give more than 40mg of citalopram a
day and never more than 20 to the adult over 65??
it will cause too great a difference in the q-t interval and confers no additional
therapeutic effect so DON"T give this to anyone with cardiac issues and only
give 20mg to the older adult! -ANSWER
absolutely do NOT exceed 20mg of citalopram in the patient who is taking
what?
PPIs –ANSWER.
, Does escitalopram have any clinical advantage over citalopram? YES!
this one has ZERO drug-drug interaction, lower doses give the same
therapeutic effect WITHOUT q-t interval!
Tagemet (cimetidine)
Pepcid (famotidine) Zantac (rantidine)-ANSWER.
which one should NEVER be taken by the older
adult?
Tagamet should NOT be taken by the older adult, but the other two are fine
do NOT use-ANSWER.
what type of insulin with the older adult?
sliding scale - instead, do meal titration and pre-meal insulin aka correction
insulin - for temporary illness what is approved by the beers list to treat
dyspareunia, lower uti and other vaginal symptoms topical estrogen cream
A1c goal in the frail older adult?
8 what statin therapy do we avoid in the older frail adult with co-
morbidities? high intensity - Atorvastatin 40-80 and Rosuvastatin 20-40
What is the nature of evidence according to USPSTF for statin therapy in the
adult age 76 or older without cardiac history?
insufficient evidence - but if they do have established heart disease it is still
recommended just moderate dose NOT high doses important parts of the
nurse practice act also, NP practice varies state to state from autonomous to
restrictive and the practice act also carries promise of actions that will
happen if a nurse violates these. Different state to state!