Beer Criteria

Beer Criteria

1. What is the Beer Criteria, and what is its’ significance in prescribing?

Beer criteria are the guidelines set by the American Geriatrics Society (AGS) (2015) to help health practitioners in attaining accurate and safe prescriptions in older adults of 65 years and above (Steinman, Beizer, DuBeau, Laird,  Lundebjerg, & Mulhausen, 2015). The criteria were established because it was noted that some medications were inappropriate in some circumstances, with older people being the most vulnerable population affected by inappropriate medications. Hence, it set the conditions in which some medications, especially antidepressants, are not applicable to older people.

2. What is the safest method of calculating a medication dose for pediatric patient?

Dosages for children are difficult to determine because they are not readily available in the extrapolation studies that are based on adult studies. Hence, it depends on either the body weight or the age of the child or both (O’Hara, 2016). The units of measuring the drug quantities for children must be in kilograms instead of pounds (1 kg= 2.2 lb). The dose (in milliliters or milligrams) is divided by the frequency (day). There is a need for clarification when the mL or mg is used. Orders written as mg/kg/d are confusing and may require more clarification.

3. At what time period in a pregnancy, can medication potentially have the greatest risk of causing malformations?

The critical age of development is the first trimester and is also the time that the fetus is most vulnerable for malformations that are caused by medication. Specifically, between 13 to 60 days of pregnancy (mothertobaby.org, 2010).

4. If your patient sometimes forgets to take her medication, what type of medication half-life would be beneficial?

A patient who misses a dose once in the medication period can always forgive the day he missed without considering the necessity of a half-lifee medication (MacGregor, 2011). What to do is to follow the remaining doses to the latter consistently.

5. Your patient is on the highest daily dose of his medication, and it is not giving him the desired effect. What type of metabolizer is he with this medication?

The appropriate metabolizer is cytochrome p450 enzymes.  This is the enzyme that can activate activities in the liver, where most of the breakdown takes place because they are ultra-rapid enzymes (Hankinson, 2016). Ultra-rapid enzymes have the effects of breaking down the drugs before they can have any effects.

6. What food item interacts with many medications and should be asked about its’ ingestion, especially in the elderly?

Foods like smoked fish, chocolate, beers, aged cheese, and processed meat have amino acid geriatrics society(tyramine) that when mixed with monoamine oxidase inhibitors can cause problems in the composition of the blood (fda.gov, 2020). Hence, it is good to ask if the older patient ingests them before administering any medication.

References

As You Age: You and Your Medicines. (2019). U.S. Food and Drug Administration. Retrieved 6 January 2020, from https://www.fda.gov/drugs/drug-information-consumers/you-age-you-and-your-medicines

Hankinson, O. (2016). The role of AHR-inducible cytochrome P450s in metabolism of polyunsaturated fatty acids. Drug metabolism reviews, 48(3), 342-350.

MacGregor, T. R. (2011). “Forgiving” a missed daily dose. AIDS research and human retroviruses, 27(4), 345-346.

O’Hara K. (2016). Paediatric pharmacokinetics and drug doses. Australian prescriber, 39(6), 208–210. doi:10.18773/austprescr.2016.071

Steinman, M. A., Beizer, J. L., DuBeau, C. E., Laird, R. D., Lundebjerg, N. E., & Mulhausen, P. (2015). How to Use the American Geriatrics Society 2015 Beers Criteria-A Guide for Patients, Clinicians, Health Systems, and Payors. Journal of the American Geriatrics Society, 63(12), e1–e7. doi:10.1111/jgs.13701