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Pharmacology and the Elderly Trauma Patient
Release and Expiration Dates
Released: 3/12/2021
Expires:    3/11/2027
Last Reviewed Date
3/12/2021, 3/14/2024
Pharmacology and the Elderly Trauma Patient

Pharmacology and the Elderly Trauma Patient is a TCAA course created from a webinar providing information about the effects of polypharmacy on the elderly trauma patient. Trauma is the fifth leading cause of death in the elderly population and accounts for up to 25% of all trauma admissions nationally. The geriatric population usually brings to the trauma bay a mixture of multiple comorbidities, polypharmacy, decreased functional reserve, and increased risk for morbidity and mortality. 

Estimated completion time:
90 minutes
Target Audience: The trauma healthcare team and other clinical departments

Learning Objectives:
At the conclusion of this course, the learner should be better able to:
1. Describe current medications and how they can alter the management of elderly patients with acute traumatic injuries

2. Identify the differences in metabolism pharmacokinetics
3. Discuss multi-modal medication regimens for the elderly patient 

Faculty Presenter: Dr. Jason Young

Faculty Bio:

Dr. Young's interests are in trauma, surgical critical care, acute care surgery, clinical research, and education. His research and education interests are in balanced crystalloid resuscitation, acute care surgery, trauma simulation, simulation debriefing, trauma outreach, and teaching/directing educational courses in advanced surgical skills for exposure in trauma. Dr. Young's current active research projects are looking at trauma simulation debriefing and studying the effects of non-technical skills during trauma simulations pre and post education (video and lecture) sessions. Additionally, he is the lead investigator in a study looking at cost benefit analysis of using MRSA PCR nasal swabs to de-escalate the use of vancomycin at an earlier time period during treatment in our Surgical ICU.

Peer Reviewer
Jacqueline Lee
Shahrzad Talebinejad
Jennifer M Watters
References
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Bulger, E., Arenson, M., Mock, C., Jurkovich, G. Rib Fractures in the Elderly. The Journal of Trauma: Injury, Infection, and Critical Care. 48(6):1040-1047, June 2000.

Butcher, S.K., Killampalli, V., Chahal, H., Kaya Alpar, E., Lord, J.M. Effect of Age on Susceptibility to Post-Traumatic Infection in the Elderly. Biochem Soc Trans (2003) 31(2):449-451

Crowley, E., Bastiaan, T., Sallevelt, B., Huibers, C., Murphy, K., Spruit, M., Shen, Z., Boland, B., Spinewine, A., Dalleur, O., Moutzouri, E., Lowe, A., Feller, M., Schwab, N., Adam, L., Wilting, I., Knol, W., Rodondi, N., Byrne, S., O’Mahony, D. Intervention Protocol: OPtimising thERapy to prevent avoidable hospital Admission in the Multi-morbid elderly (OPERAM): a structured medication review with support of a computerized decision support system. BMC Health Services Research 20, 220 (2020)

DeAntonio, J., Leichtle, S., Hobgood, S., Boomer, L., Aboutanos, M., Mangino, M., Wijesinghe, D., Jayaraman, S. Medication Reconciliation and Patient Safety in Trauma: Applicability of Existing Strategies. Journal of Surgical Research. 246(Feb 2020):482-489

Fallon Jr., W., Rader, E., Zyzanski, S., Mancuso, C., Martin, B., Breedlove, L., DeGolia, P., Allen, K., Campbell, J. Geriatric Outcomes are Improved by a Geriatric Trauma Consultation Service; The Journal of Trauma: Injury, Infection, and Critical Care. 61(5):1040-1046, Nov 2006.

Frankenfield, D., Cooney, R., Smith, J., Rowe, W. Age-Related Differences in the Metabolic Response to Injury. The Journal of Trauma: Injury, Infection, and Critical Care. 48(1): 49, Jan 2000.

Ivascu, F. Howell, g., Junn, F., Bair, H., Bendick, P., Janczyk, R. Rapid Warfarin Reversal in Anticoagulated Patients with Traumatic Intracranial Hemorrhage Reduces Hemorrhage Progression and Mortality. The Journal of Trauma: Injury, Infection, and Critical Care. 59(5):1131-1139, Nov 2005.

Kozar, R., Arbabi, S., Stein, D., Shackford, S., Barraco, R., Biffl, W., Brasel, K., Cooper, Z., Fakhry, S., Livingston, D., Moore, F., Luchette, F. Injury in the Aged: Geriatric Trauma Care at the Crossroads. Journal of Trauma and Acute Care Surgery. 78(6):1197-1209, June 2015.

Lenartowicz, M., Parkovnick, M., McFarlan, A., Haas, B., Straus, S., Nathens, A., Wong, C. An Evaluation of a Proactive Geriatric Trauma Consultation Service. Ann Surg 202 Dec; 256(6): 1098-101

Lewis, M., Abouelenin, K., Paniagua, M. Geriatric Trauma: Special Considerations in the Anesthetic Management of the Injured Elderly Patient. Anesthesiology Clin. 25(2007) 75-90

Makary, M., Segev, D., Pronovost, D., Bandeen-Roche, K., Patel, P., Takenaga, R., Devgan, L., Holzmueller, C., Tian, J., Fried, L. Frailty as a predictor of surgical outcomes in older patients., Journal American College of Surgeons. 2010 June; 210(6):901-8.

Muhlbert, W., Platt, D. Age-dependent Changes of the Kidneys: Pharmacological Implications. Gerontology. Sep-Oct 1999;45(5):243-53

Neideen, T., Lam, M., Brasel, K. Preinjury Beta Blockers are Associated with Increased Mortality in Geriatric Trauma Patients. The Journal of Trauma: Injury, Infection, and Critical Care. 65(5):1016-1020, Nov. 2008.

O’Mahony, D., Gudmundsson, A., Soiza, R., Petrovic, M., Cruz-Jentoft, A. Prevention of Adverse Drug Reactions in Hospitalized Older Patients with Multi-morbidity and Polypharmacy: The SENATOR randomized controlled clinical trial. Age and Ageing, 49(4); 605-614 July 2020

Stein, D., Kozar, R., Livingston, D., Luchette, F., Adams, S., Agrawal, V., Arbabi, S., Ballou, J., Barraco, R., Bernard, A., Biffl, W., Bosarge, P., Brasel, K., Cooper, Z., Efron, P., Fakhry, S., Hartline, S., Hwang, F., Joseph, B., Kurek, S., Moore, F., Mosenthal, A., Pathak, A., Truitt, M., Yelon, J. AAST Geriatric Trauma/ACS Committee. Geriatric Traumatic Brain Injury: What We Know and What We Don’t. Journal of Trauma Acute Care Surg. 2018 Oct; 85(4):788-798.

Todd, S., McNally, M., Holcomb, J., Kozar, R., Kao, L., Gonzalez, E., Cocanour, C., Vercruysse, G., Lygas, M., Brasseaux, B., Moore, F. A multidisciplinary clinical pathway decreases rib fracture–associated infectious morbidity and mortality in high-risk trauma patients. American Journal of Surgery 192 (2006) 806-811
Summary
Availability: On-Demand
Cost: FREE
Credit Offered:
1.5 CE Credits
1.5 COP Credits
1.5 TCAA CME Credits
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