CCP Geriatric Pharmacology 3

Question 1

A 75-year-old with chronic pain is prescribed an NSAID. Which complication is most concerning due to age-related changes in renal prostaglandin dependence?

Accepted Answer

Acute kidney injury

Answer

Elderly patients rely more heavily on prostaglandins to maintain renal blood flow, making NSAID-induced acute kidney injury especially common in this population.

Question 2

Which antihypertensive drug class is associated with increased risk of hyponatremia in elderly patients, particularly women?

Accepted Answer

Thiazide diuretics

Answer

Thiazide diuretics, especially hydrochlorothiazide, frequently cause hyponatremia in elderly patients due to impaired water excretion and syndrome of inappropriate ADH.

Question 3

An elderly patient on digoxin develops nausea, visual disturbances, and bradycardia. Which electrolyte abnormality most likely precipitated toxicity?

Accepted Answer

Hypokalemia

Answer

Hypokalemia sensitizes the myocardium to digoxin toxicity by competing for the same Na-K-ATPase binding site, even at therapeutic digoxin levels.

Question 4

According to the STOPP/START criteria, which medication should be STARTED in an eligible elderly patient that is commonly omitted?

Accepted Answer

Prophylactic anticoagulation in atrial fibrillation with high stroke risk

Answer

START criteria identify underuse of beneficial therapies; anticoagulation for AF with high stroke risk (CHA2DS2-VASc ≥2) is frequently omitted in elderly due to bleeding concerns.

Question 5

Which opioid is listed on the Beers Criteria as particularly problematic in elderly patients due to its toxic metabolite accumulation?

Accepted Answer

Meperidine

Answer

Meperidine's metabolite normeperidine accumulates in elderly due to reduced renal clearance and causes CNS excitation, seizures, and delirium.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Geriatric Pharmacology 3