Pharmacology & Medication Management in Aging Patients Flashcards
6 cards from real Adult-Gerontology Primary Care Nurse Practitioner Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Pharmacology & Medication Management in Aging Patients flashcards as text
A 79-year-old is prescribed warfarin for atrial fibrillation. Which factor unique to aging increases bleeding risk?
Answer: Increased sensitivity to vitamin K antagonism and altered CYP2C9 activity
Older adults have increased pharmacodynamic sensitivity to warfarin and reduced CYP2C9 metabolism, requiring lower doses and more frequent INR monitoring.
The STOPP criteria (Screening Tool of Older Persons' Potentially inappropriate Prescriptions) is used alongside the START criteria to:
Answer: Identify medications to stop AND medications that should be started
STOPP identifies inappropriate medications to discontinue, while START identifies evidence-based medications that are indicated but potentially omitted in older patients.
An older adult is started on a fluoroquinolone antibiotic. The AGPCNP should monitor for which serious adverse effect particularly concerning in this age group?
Answer: Tendonitis or tendon rupture
Fluoroquinolones carry an FDA black box warning for tendinopathy and tendon rupture, with older adults and those on corticosteroids at highest risk.
Which of the following opioid analgesics should be avoided in older adults due to accumulation of toxic metabolites causing neurotoxicity?
Answer: Meperidine (Demerol)
Meperidine accumulates its active metabolite normeperidine in older adults, causing CNS toxicity including tremors, myoclonus, and seizures.
A patient taking methotrexate for rheumatoid arthritis should also receive which supplement to reduce toxicity?
Answer: Folic acid
Folic acid supplementation reduces methotrexate-associated mucositis, GI toxicity, and hepatotoxicity without compromising its therapeutic efficacy.
In polypharmacy management, deprescribing refers to:
Answer: The planned and supervised process of dose reduction or stopping medications no longer needed
Deprescribing is an evidence-based, patient-centered process of withdrawing inappropriate medications to reduce polypharmacy burden and improve outcomes.
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