Chronic Disease Management in Older Adults Flashcards

A 74-year-old patient with type 2 diabetes also has established atherosclerotic cardiovascular disease. Which medication has both glycemic and cardiovascular mortality benefit?

Answer: Empagliflozin (SGLT-2 inhibitor)

SGLT-2 inhibitors such as empagliflozin have demonstrated cardiovascular mortality reduction in patients with established ASCVD and are recommended by the ADA for this population.

In an older adult with chronic kidney disease and anemia, the hemoglobin target when using erythropoiesis-stimulating agents (ESAs) should be:

Answer: 10–11 g/dL

ESA therapy in CKD-related anemia should target hemoglobin of 10–11 g/dL; higher targets are associated with increased cardiovascular events and stroke.

The AGPCNP is treating an 80-year-old with symptomatic benign prostatic hyperplasia (BPH). Which medication class is typically avoided due to falls risk in older adults?

Answer: Alpha-1 blockers (e.g., tamsulosin)

Alpha-1 blockers can cause orthostatic hypotension and syncope, significantly increasing falls risk in older men, although tamsulosin is considered relatively uroselective.

When managing chronic obstructive pulmonary disease (COPD) in an older adult, the preferred bronchodilator for maintenance therapy is:

Answer: Long-acting muscarinic antagonist (LAMA)

LAMA bronchodilators (e.g., tiotropium) are preferred first-line maintenance therapy for stable COPD as they reduce exacerbations and improve quality of life.

A 77-year-old woman with a recent hip fracture has a T-score of -3.1. After initiating bisphosphonate therapy, bone density follow-up with DXA should occur:

Answer: Every 1–2 years

Following initiation of osteoporosis treatment, DXA is typically repeated every 1–2 years to monitor treatment response and guide therapy decisions.

An older adult with GERD who has failed lifestyle modifications should be treated with which of the following as first-line pharmacotherapy?

Answer: Proton pump inhibitors (PPIs)

PPIs are the most effective first-line pharmacotherapy for GERD, providing superior acid suppression compared to H2 blockers; however, long-term use should be reassessed regularly in older adults.