Which rationale explains why anticonvulsants and antidepressants have an exaggerated effect in older adult clients?
1. Increased binding to plasma proteins such as albumin
2. Increased rate of hepatic metabolism
3. Reduced intestinal transit time
4. Declining efficiency of the blood–brain barrier
Correct Answer: 4
Rationale 1: Binding to plasma proteins such as albumin is typically decreased, not increased, with age. Additionally, an increase in protein binding would result in diminished, not exaggerated, effects.
Rationale 2: Hepatic metabolism is typically decreased, not increased, with age. Additionally, an increase in metabolism would result in diminished, not exaggerated, effects.
Rationale 3: Intestinal transit time is increased due to the decrease seen in gastrointestinal motility. Additionally, the increase in intestinal transit time would diminish, not exaggerate, the effect of medications.
Rationale 4: Declining efficiency of the blood–brain barrier could explain an increase in the effects of drugs that work in the brain such as anticonvulsants or antidepressants.
Global Rationale: Declining efficiency of the blood–brain barrier could explain an increase in the effects of drugs that work in the brain such as anticonvulsants or antidepressants. Binding to plasma proteins such as albumin is typically decreased, not increased, with age. Additionally, an increase in protein binding would result in diminished, not exaggerated, effects. Hepatic metabolism is typically decreased, not increased, with age. Additionally, an increase in metabolism would result in diminished, not exaggerated, effects. Intestinal transit time is increased due to the decrease seen in gastrointestinal motility. Additionally, the increase in intestinal transit time would diminish, not exaggerate, the effect of medications.
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