1.
ADRs in geriatric patients:
Correct Answer
D. A and B
Explanation
ADRs in geriatric patients may occur due to inappropriate medication prescribing and may mimic conditions of old age. This means that the side effects experienced by older patients can be a result of medications that have been prescribed inappropriately for their age group. Additionally, some adverse drug reactions can manifest as symptoms that are commonly associated with old age, making it difficult to distinguish between medication side effects and natural aging processes. Therefore, both options A and B are correct.
2.
Which of the following factors is important to consider when selecting and monitoring medication therapy in geriatric patients?
Correct Answer
D. A, B, and C
Explanation
When selecting and monitoring medication therapy in geriatric patients, it is important to consider the presence of concurrent disease states, the cost of therapy, and the patient's renal function. Geriatric patients often have multiple health conditions, which can affect the choice and effectiveness of medications. The cost of therapy is important to ensure affordability and adherence to treatment. Additionally, the patient's renal function is crucial as it can impact the metabolism and elimination of drugs from the body. Considering all these factors together helps to optimize medication therapy in geriatric patients.
3.
T.D. is a 68-year-old female brought to the ED with a fracture of the left arm after falling at home. She says that she became dizzy before falling. Which of the following medications may have contributed to this patient’s fall?
Correct Answer
C. Haloperidol
Explanation
Haloperidol is an antipsychotic medication that is commonly associated with dizziness and orthostatic hypotension as side effects. These side effects can increase the risk of falls, especially in elderly patients like T.D. Therefore, it is likely that Haloperidol may have contributed to this patient's fall. Atorvastatin is a statin used for cholesterol management and is not typically associated with dizziness or falls. Famotidine is an H2 blocker used for acid reflux and is also not commonly associated with dizziness or falls. Therefore, the correct answer is Haloperidol.
4.
Sexual activity in the elderly is most associated with:
Correct Answer
A. Partner availability
Explanation
As people age, the availability of a sexual partner becomes a significant factor in their sexual activity. Older adults who have a partner are more likely to engage in sexual activities compared to those who are single or widowed. This is because having a partner provides the opportunity and motivation for sexual intimacy. Factors like frequency of sexual activities when younger and cognitive status may have some influence, but partner availability is the most closely associated with sexual activity in the elderly.
5.
A 68-year-old woman presents with a several-day history of acute agitation, food refusal, delusions of nihilism, and auditory hallucinations. She has a history of chronic bipolar disorder and more recent cognitive and functional decline. The mini-mental status examination (MMSE) score was 24/30. What is the most appropriate treatment at this time?
Correct Answer
D. Electroconvulsive therapy
Explanation
Electroconvulsive therapy (ECT) is the most appropriate treatment at this time for this patient. The patient's symptoms, including acute agitation, food refusal, delusions, and auditory hallucinations, suggest a severe psychiatric condition that requires immediate intervention. ECT is an effective treatment option for severe psychiatric disorders, especially when there is a risk of harm to self or others. Additionally, the patient's history of cognitive and functional decline, along with a MMSE score of 24/30, indicates a possible underlying neurodegenerative disorder, which may further support the use of ECT in this case.
6.
The following is characteristic of geriatric psychopharmacology/drug metabolism in the elderly:
Correct Answer
C. Decreased hydroxylation
Explanation
In geriatric psychopharmacology, the process of hydroxylation, which is the addition of a hydroxyl group to a drug molecule, is decreased in the elderly. This means that the metabolism of drugs that undergo hydroxylation is impaired, leading to slower breakdown and elimination from the body. This can result in increased drug levels and prolonged effects, increasing the risk of adverse reactions and drug interactions in the elderly population.
7.
In bipolar elderly, regarding mania and depression, cycles become:
Correct Answer
D. More frequent, increased amplitude
Explanation
As elderly individuals with bipolar disorder age, their cycles of mania and depression tend to become more frequent and have increased amplitude. This means that they experience more episodes of both mania and depression, and these episodes are more intense and severe. This pattern is commonly observed in older adults with bipolar disorder and may be attributed to various factors such as changes in brain chemistry, medication adjustments, and overall decline in physical and mental health.
8.
Which of the following medications may need dosage adjustments in geriatric patients because of decreased renal function?
Correct Answer
D. B and C
Explanation
Geriatric patients often experience a decline in renal function, which can affect the clearance of certain medications from their system. Atorvastatin, a statin used to lower cholesterol, is primarily metabolized by the liver and does not require dosage adjustments based on renal function. Famotidine, a medication used to reduce stomach acid, and Dabigatran, an anticoagulant, both undergo renal elimination and may require dosage adjustments in geriatric patients with decreased renal function. Therefore, the correct answer is B and C.
9.
Geriatric patients may require smaller doses of medications than younger patients because of:
Correct Answer
D. All of these
Explanation
Geriatric patients may require smaller doses of medications than younger patients because of several factors. Firstly, they may experience decreased hepatic metabolism, meaning their liver may not be as efficient in processing and metabolizing drugs. Secondly, they may have decreased renal function, which affects the clearance and elimination of medications from the body. Lastly, geriatric patients often have decreased lean body mass, which can affect the distribution and concentration of drugs in their system. Therefore, all of these factors contribute to the need for smaller medication doses in geriatric patients.
10.
Geriatric patients exhibit an altered pharmacodynamic response to which of the following classes of medications?
Correct Answer
B. Beta blocking agents
Explanation
Geriatric patients exhibit an altered pharmacodynamic response to beta blocking agents. This means that the way their bodies respond to these medications is different compared to younger patients. Geriatric patients may experience a greater reduction in heart rate and blood pressure when taking beta blockers, which can increase the risk of side effects such as dizziness and falls. Therefore, special caution and monitoring are required when prescribing beta blockers to older patients.