pearljam59
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Lets say a patient takes midazolam for an endoscopy procedure. He then experiences toxic effects (cyanosis and labored respirations) of the drug. Say this guy is 80 years old. What is it that happens to his body as a result of age that causes these adverse effects?!
A. Enterohepatic recycling
B. Metabolite formation
C. Plasma protein binding
D. Sensitivity to sedatives
E. Volume of distribution
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| skyhigh
Forum Guru
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a
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| tolito
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E.
the elderly have increased proportion of fat and decreased total body water which would tend to inc the conc of drugs. they are also more sensitive to sedatives but i think VD would have more effect in producing toxicity.
check out http://www.calregistry.com/dyk/drug.htm
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| robin082006
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E
it is also explained in Kaplan Q bank
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| docswapna
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D or E?
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| DanVitor
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Ok, I was very confused with this question...
I will quote Katzung Pharmacology Examination & Board Review 7th Edition:
" Decreased blood flow to vital organs, includin the liver and kidney, occurs during aging process. These changes MAY contribute to cumulative effects of sedative-hypnotic drugs. However, this DOES NOT explain the enchanced sensitivity of the elderly pacient to a SINGLE dose of a central depresant, which appears to be due to changes in brain function that accompany aging."
Page 199, Answer on question 9...
A. Enterohepatic recycling >> This is not likely
B. Metabolite formation >> This is likely, but not in elderly pacient, coz their metabolite formation is DECREASED and it would not expain INSTANT symptoms.
C. Plasma protein binding >>> This would decrease available free drug fraction in blood which is responsible for drug effects
D. Sensitivity to sedatives >>> I would take this one nod
E. Volume of distribution >>> If VOD is increased, it would decrease free drug in plasma and PROLONG time of elimination, but it would not INCREASE free active drug in blood in first few minutes.
Please comment!!!
P.S. I don't know how to use italics in this window, so please, don't be offended with CAPITALs!
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| klimt
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I think the original q was 'what increases' in his body, and as he is 80 years old, metabolism is faster since he loses phase I so....how about B?
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