BCG BCG Pharmacology & Medication Management in Older Adults 3

Question 1

In an older adult, the volume of distribution (Vd) of fat-soluble drugs typically:

Accepted Answer

Increases because body fat percentage increases with age, prolonging drug effect

Answer

Decreases because older adults have less lean body mass

Answer

Remains unchanged relative to younger adults

Answer

Increases only in malnourished patients

Question 2

Which medication used for overactive bladder is most problematic for cognitively vulnerable older adults?

Accepted Answer

Oxybutynin

Answer

Mirabegron

Answer

Tamsulosin

Answer

Finasteride

Question 3

When using the STOPP/START tool in geriatric medication review, the START criteria identify:

Accepted Answer

Evidence-based medications that are potentially under-prescribed in older adults

Answer

Medications that should be stopped due to adverse risk

Answer

Drug interactions requiring dose reduction

Answer

Medications contraindicated in renal impairment

Question 4

An older adult with insomnia asks about sleep aids. Which agent is considered safest compared to alternatives?

Accepted Answer

Low-dose melatonin with sleep hygiene education

Answer

Diphenhydramine (Benadryl)

Answer

Lorazepam

Answer

Zolpidem

Question 5

Which pharmacodynamic change in older adults increases sensitivity to CNS-depressant drugs even at standard doses?

Accepted Answer

Increased CNS receptor sensitivity and decreased homeostatic reserve

Answer

Decreased blood-brain barrier permeability

Answer

Reduced receptor sensitivity throughout the body

Answer

Faster hepatic metabolism of CNS drugs

Question 6

A gerontological nurse is reviewing a patient's medications and finds duplicate therapy. Which situation best exemplifies this?

Accepted Answer

A patient prescribed both naproxen and ibuprofen for pain

Answer

A patient taking both lisinopril and amlodipine

Answer

A patient receiving metformin and insulin simultaneously

Answer

A patient on both a statin and a fibrate