Slower liver and kidney clearance lets drugs accumulate to toxic levels at usual amounts.
Before you read
Test yourself first: 1 question
Question 1 of 1
Forty minutes after naloxone restored her breathing, a patient who took an extended-release opioid becomes drowsy again with a respiratory rate of 6. Why?
Answer: A. Naloxone has a shorter duration of action than many opioids, particularly extended-release and long-acting agents, so respiratory depression can return once the antagonist wears off. This is why patients reversed by naloxone need continued monitoring. It is not an allergy, naloxone has no opioid activity, and assuming a new ingestion misses the predictable pharmacology.
Keep the streak going with more questions like these, each with a full rationale.
What is geriatric pharmacology?
Many geriatric calls are medication calls in disguise, and many medications hide the vital-sign changes the assessment depends on.
Key points to remember
- Slower liver and kidney clearance lets drugs accumulate to toxic levels at usual amounts.
- Polypharmacy multiplies interactions; falls and confusion are common presenting complaints.
- Beta blockers can blunt the tachycardia of shock — a normal heart rate does not rule it out.
- Anticoagulants turn minor head trauma into a possible intracranial bleed.
- Anticholinergic and sedating drugs are a common, reversible cause of delirium.
Field priorities
- Bring the medication list or containers; ask about recent changes and missed or doubled doses.
- Treat a fall on an anticoagulant as a high-risk head injury.
- Check glucose in any older adult with new confusion.
Coaching the patient
- Delirium comes on over hours to days and fluctuates; dementia is slow and steady — new confusion is an emergency until proven otherwise.
Red flags: act now
- Bradycardia with dizziness in a patient on rate-control drugs
- Head strike on an anticoagulant
- Sudden confusion after a new medication
Geriatric Pharmacology: FAQs
What are the priority actions for Geriatric Pharmacology in the field?
Bring the medication list or containers; ask about recent changes and missed or doubled doses. Treat a fall on an anticoagulant as a high-risk head injury. Check glucose in any older adult with new confusion.
What findings in Geriatric Pharmacology change your plan or your transport decision?
Bradycardia with dizziness in a patient on rate-control drugs. Head strike on an anticoagulant. Sudden confusion after a new medication.
What do I need to know about Geriatric Pharmacology for the NREMT?
Slower liver and kidney clearance lets drugs accumulate to toxic levels at usual amounts. Polypharmacy multiplies interactions; falls and confusion are common presenting complaints. Beta blockers can blunt the tachycardia of shock — a normal heart rate does not rule it out. Anticoagulants turn minor head trauma into a possible intracranial bleed.
What should the crew communicate or document for Geriatric Pharmacology?
Delirium comes on over hours to days and fluctuates; dementia is slow and steady — new confusion is an emergency until proven otherwise.
