CCP Geriatric Pharmacology 4

Question 1

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

Accepted Answer

Clostridium difficile infection

Answer

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

Question 2

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

Accepted Answer

Tendinopathy and tendon rupture

Answer

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

Question 3

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

Accepted Answer

Both drugs suppress AV nodal conduction additively

Answer

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

Question 4

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

Accepted Answer

Fall Risk Increasing Drugs (FRID) tool

Answer

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

Question 5

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

Accepted Answer

Cholinergic-mediated GI disturbances and bradycardia

Answer

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

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Geriatric Pharmacology 4