Pharmacology & Medication Management in Aging Patients Flashcards

How does aging primarily affect drug distribution in older adults?

Answer: Increased body fat increases volume of distribution for lipid-soluble drugs

With aging, body fat increases relative to lean mass, increasing the volume of distribution and prolonging the half-life of lipophilic drugs such as benzodiazepines.

The Cockcroft-Gault formula is used by the AGPCNP to estimate:

Answer: Creatinine clearance as a surrogate for GFR to guide drug dosing

The Cockcroft-Gault equation estimates creatinine clearance using age, weight, sex, and serum creatinine, guiding renally-cleared drug dosing in older adults.

Which of the following benzodiazepines is considered relatively safer in older adults due to its lack of active metabolites?

Answer: Lorazepam

Lorazepam is preferred when a benzodiazepine is necessary in older adults because it has no active metabolites and a shorter half-life, reducing accumulation risk.

The prescribing cascade occurs when:

Answer: A drug side effect is misinterpreted as a new condition and treated with another drug

The prescribing cascade is the process whereby an adverse drug effect is mistaken for a new medical condition, leading to additional prescriptions and compounding harm.

Which class of medications is listed on the Beers Criteria as potentially inappropriate in older adults due to anticholinergic effects?

Answer: First-generation antihistamines (e.g., diphenhydramine)

First-generation antihistamines like diphenhydramine have strong anticholinergic activity, causing confusion, urinary retention, constipation, and falls in older adults.

An AGPCNP conducts medication reconciliation at every visit. This process is most important for preventing:

Answer: Omission errors, duplication, and drug-drug interactions

Medication reconciliation systematically identifies discrepancies between prescribed, dispensed, and taken medications, reducing omissions, duplications, and harmful interactions.