Geriatric Pharm

Question 1

Percentage of persons > 65 on more than 7 meds

Answer 1

82%

Question 2

How many drugs quantify polypharmacy?

Answer 2

4 or more

Question 3

Most common causes of death from adverse drug reactions

Answer 3

GI bleeding, intracranial bleeding and renal failure

Question 4

How does liver metabolism of drugs change in elderly?

Answer 4

decreased hepatic blood flow and first pass metabolism

Question 5

What are the consequences of decreased liver function in drug metabolism?

Answer 5

there will be greater conc of drug that is active. will require smaller doses

Question 6

65 clinically significant criteria for potentially inappropriate prescribing in older adults. Overlaps with the Beers criteria

Answer 6

STOPP

Question 7

Screening tool of older persons’ potentially inappropriate prescriptions

Answer 7

STOPP

Question 8

Screening tool to alert prescribers to right treatment

Answer 8

START

Question 9

2 lists of medications to be avoided in older adults. 1 list of medications that should be used with caution

Answer 9

Beers criteria

Question 10

What medication class should you avoid in elderly due to risk of prolonged hypoglycemia?

Answer 10

sulfonlylureas (glyburide)

Question 11

What medication class should you avoid in elderly due to increased risk of GI bleeding, PUD?

Answer 11

non cox-selective NSAIDs

Question 12

Medications that decrease risk of GI bleeding and PUD

Answer 12

PPI or misoprostol

Question 13

Drug classes that can worsen constipation

Answer 13

antimuscarinics, nondihyropyridine Ca blockers, 1st gen antihistamines

Question 14

Name the nondihyropyridine Ca blockers

Answer 14

verapamil and diltiazem

Question 15

What do the following drug classes have in common: SNRIs, SSRIs, antipsychotics

Answer 15

May cause SIADH or exacerbate underlying syndrome

Question 16

Most commonly omitted medication that a patient would’ve benefited from according to the START study

Answer 16

statins

Question 17

What should not be considered first choice to treat behavioral and psychological symptoms of dementia?

Answer 17

antipsychotics

Question 18

What should you avoid doing in an elderly diabetic?

Answer 18

Avoid using medications to achieve A1C < 7.5%

Question 19

What medications should you avoid in elderly for insomnia, agitation, or delirium?

Answer 19

benzos

Question 20

What is first choice treatment for elderly patient with insomnia or agitation?

Answer 20

behavioral therapy

Question 21

If prescribing cholinesterase inhibitors for dementia, what should you periodically asses?

Answer 21

cognitive benefits and adverse GI effects

Question 22

What should you avoid when starting prescriptions in elderly?

Answer 22

Avoid starting 2 new meds in the same patient at one time