BCG Pharmacology & Medication Management in Older Adults Flashcards

Why is anticholinergic burden a special concern in gerontological pharmacology?

Answer: Cumulative anticholinergic effects increase risk of cognitive impairment, urinary retention, and constipation

Cumulative anticholinergic burden from multiple medications significantly increases risks of delirium, cognitive decline, constipation, and urinary retention in older adults.

Which pain medication class requires particular caution in older adults due to the risk of GI bleeding, renal impairment, and cardiovascular events?

Answer: NSAIDs

NSAIDs are associated with GI bleeding, acute kidney injury, and cardiovascular events, making them high-risk in older adults who often have multiple comorbidities.

When adjusting opioid doses for older adults, the standard recommendation is to:

Answer: Start low and go slow, beginning at 25–50% of the typical adult dose

The 'start low, go slow' principle reduces the risk of over-sedation, respiratory depression, and falls in older adults with altered opioid metabolism.

A patient taking warfarin is started on a new antibiotic. What is the primary pharmacological concern?

Answer: Antibiotics can alter gut flora and inhibit CYP enzymes, elevating INR and bleeding risk

Many antibiotics inhibit gut bacteria that produce vitamin K and inhibit CYP2C9, leading to elevated warfarin levels and increased bleeding risk.

Which is the preferred approach for managing medication reconciliation during care transitions for older adults?

Answer: Conduct a comprehensive medication review comparing all medication lists from sending and receiving facilities

Comparing medication lists from all care settings during transitions is essential to identify discrepancies, omissions, and duplications that cause adverse drug events.

Which supplement commonly taken by older adults can significantly interact with blood thinners and increase bleeding risk?

Answer: Fish oil (omega-3 fatty acids)

High-dose omega-3 fatty acids have antiplatelet properties and can potentiate the anticoagulant effects of warfarin and other blood thinners.