Today’s NCLEX-RN® question of the day focuses on the way old age can influence drug administration.
The nurse is administering medications to an 80-year-old client. Which of these age-related physiologic changes should the nurse consider when assessing the client’s response to the medications?
A. Decreased glomerular filtration rate (GFR) may lead to drug toxicity
B. Decreased fat stores lead to poor medication distribution
C. An age-related decrease in gastric acidity increases medication absorption
D. Metabolism of medications increases with age
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The correct answer to today’s NCLEX-RN® Question is…
A. Decreased glomerular filtration rate (GFR) may lead to drug toxicity
Rationale: Age-related decreases in GFR may lead to drug accumulation and toxicity.
Main Takeaway
There is a gradual decline in organ function during the aging process which can affect pharmacokinetics. Examples of age-related physiologic changes in the older adult include decreased GFR, which can result in slower excretion of medications; decreased gastric acidity, which may slow absorption of medications; decreased albumin, which affects protein binding and drug distribution; and decreased hepatic enzyme activity, which may delay or decrease metabolism of medications. These changes in organ function increase the risk of adverse drug reactions in older adults.
Incorrect Answer Explanations
B. Decreased fat stores lead to poor medication distribution
Rationale: With age, body fat generally increases and total body water decreases. Increased fat increases the volume of distribution for highly lipophilic drugs, such as diazepam and chlordiazepoxide, and may increase their elimination half-lives.
C. An age-related decrease in gastric acidity increases medication absorption
Rationale: Physiologic changes affecting pharmacokinetics in older adults includes a decrease in gastric acidity, which may also slow absorption of certain medications.
D. Metabolism of medications increases with age
Rationale: Physiologic changes affecting pharmacokinetics in older adults include hepatic changes such as decreased blood flow to the liver and decreased activity of hepatic enzymes. These changes may delay or decrease metabolism of medications rather than increase it.
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References
- Burchum, J. R., & Rosenthal, L. D. (2019). Lehne’s pharmacology for nursing care (10th ed.). St. Louis, MO: Elsevier.
- Ruscin, M. & Linnebur, S. (2021). Pharmacokinetics in older adults. Retrieved from: https://www.merckmanuals.com/professional/geriatrics/drug-therapy-in-older-adults/pharmacokinetics-in-older-adults
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