CCP Geriatric Pharmacology 5

Question 1

Which clinical framework provides a structured approach for deprescribing unnecessary medications in elderly patients through systematic review?

Accepted Answer

Medication Appropriateness Index (MAI)

Answer

The Medication Appropriateness Index (MAI) evaluates 10 criteria for each medication to determine clinical appropriateness and guide deprescribing decisions.

Question 2

An elderly patient with osteoporosis is on long-term corticosteroids. Which medication should the consultant pharmacist ensure is co-prescribed for bone protection?

Accepted Answer

Calcium and vitamin D supplementation plus bisphosphonate therapy

Answer

Glucocorticoid-induced osteoporosis management requires both calcium/vitamin D supplementation and anti-resorptive therapy (bisphosphonate) for adequate bone protection.

Question 3

Which strategy best describes the pharmacist's role in preventing medication-related falls in a 77-year-old with hypertension on three antihypertensives?

Accepted Answer

Review for orthostatic hypotension and recommend dose reduction or deprescribing of redundant agents

Answer

Reviewing for orthostatic hypotension and simplifying the antihypertensive regimen reduces fall risk while maintaining adequate blood pressure management in elderly.

Question 4

A nursing home patient develops confusion after receiving diphenhydramine for insomnia. What is the mechanism underlying this reaction?

Accepted Answer

Diphenhydramine's anticholinergic properties impair central cholinergic neurotransmission

Answer

Diphenhydramine's strong anticholinergic activity blocks central muscarinic receptors, causing delirium, confusion, and cognitive impairment especially in the elderly.

Question 5

Which age-related change in hepatic function primarily reduces the clearance of high-extraction drugs like propranolol and lidocaine?

Accepted Answer

Reduced hepatic blood flow

Answer

High-extraction drugs depend on hepatic blood flow for clearance; since blood flow decreases 30-40% with aging, these drugs' clearance falls and bioavailability increases.

(CCP) Certified Consultant Pharmacist Practice Test

(CCP) Certified Consultant Pharmacist Practice Test

CCP Geriatric Pharmacology 5