CCP Geriatric Pharmacology 2

Question 1

Which pharmacokinetic change is most consistently observed in elderly patients due to decreased lean body mass?

Accepted Answer

Decreased volume of distribution for lipophilic drugs

Answer

Decreased lean body mass in elderly reduces the volume of distribution for lipophilic drugs, potentially increasing plasma concentrations.

Question 2

An 80-year-old with a normal serum creatinine of 0.8 mg/dL is prescribed a renally cleared antibiotic. What is the most appropriate next step?

Accepted Answer

Calculate CrCl using Cockcroft-Gault to account for reduced muscle mass

Answer

A low serum creatinine in elderly often reflects reduced muscle mass, not good renal function; Cockcroft-Gault CrCl calculation is essential.

Question 3

Which agent is considered potentially inappropriate per the Beers Criteria for older adults due to the risk of hypoglycemia?

Accepted Answer

Glyburide

Answer

Glyburide is a long-acting sulfonylurea with active metabolites that accumulate in elderly, significantly increasing hypoglycemia risk.

Question 4

What is the primary reason first-pass metabolism is often reduced in elderly patients?

Accepted Answer

Decreased hepatic blood flow and liver mass

Answer

Aging reduces hepatic blood flow and liver mass by up to 40%, decreasing first-pass extraction and increasing oral bioavailability of high-extraction drugs.

Question 5

An elderly patient on warfarin begins taking trimethoprim-sulfamethoxazole for a UTI. What is the expected outcome?

Accepted Answer

INR increases due to CYP2C9 inhibition

Answer

TMP-SMX inhibits CYP2C9, the primary enzyme metabolizing warfarin's S-enantiomer, leading to elevated INR and bleeding risk.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Geriatric Pharmacology 2