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Geriatric Pharmacology Flashcards

7 cards from real CCP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Geriatric Pharmacology flashcards as text

  1. Which proton pump inhibitor-related adverse effect is of greatest concern with long-term use in elderly nursing home patients?

    Answer: Clostridium difficile infection

    Long-term PPI use raises gastric pH, promoting C. difficile colonization and infection, which is particularly severe and recurrent in elderly institutionalized patients.

  2. An 82-year-old is started on a fluoroquinolone for pneumonia. Which specific adverse effect warrants special monitoring in geriatric patients?

    Answer: Tendinopathy and tendon rupture

    Fluoroquinolones significantly increase the risk of tendinopathy and Achilles tendon rupture in elderly patients, particularly those on concurrent corticosteroids.

  3. A 76-year-old with heart failure and atrial fibrillation on carvedilol and digoxin develops symptomatic bradycardia. What is the primary pharmacodynamic interaction?

    Answer: Both drugs suppress AV nodal conduction additively

    Carvedilol and digoxin both slow AV conduction through different mechanisms (beta-blockade and vagotonic effects), causing additive bradycardia when combined.

  4. Which fall-risk medication assessment tool specifically evaluates medications known to increase fall risk in older adults?

    Answer: Fall Risk Increasing Drugs (FRID) tool

    The Fall Risk Increasing Drugs (FRID) tool systematically identifies medications associated with fall risk, including psychotropics, antihypertensives, and diuretics.

  5. An elderly patient with moderate Alzheimer's disease is prescribed donepezil. Which adverse effect is most likely due to its mechanism of action?

    Answer: Cholinergic-mediated GI disturbances and bradycardia

    Donepezil inhibits acetylcholinesterase, increasing cholinergic tone systemically, causing GI effects (nausea, diarrhea) and cardiac slowing (bradycardia, syncope).

  6. A 79-year-old on warfarin is started on amiodarone for persistent atrial fibrillation. What INR change is expected and what is the mechanism?

    Answer: INR increases; amiodarone inhibits CYP2C9 and CYP3A4

    Amiodarone potently inhibits CYP2C9 (primary warfarin metabolism) and CYP3A4, substantially increasing INR and bleeding risk; warfarin dose typically needs 30-50% reduction.

  7. Which medication change should a consultant pharmacist recommend for an elderly patient with type 2 diabetes and CKD stage 4 (eGFR 22 mL/min)?

    Answer: Discontinue metformin and avoid sulfonylureas; prefer insulin or DPP-4i with dose adjustment

    Metformin is contraindicated with eGFR <30, and glyburide's active metabolites accumulate dangerously in CKD; insulin or renally-adjusted DPP-4 inhibitors are safer alternatives.