Geriatric Pharmacotherapy Flashcards
7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Geriatric Pharmacotherapy flashcards as text
Which lab finding would most strongly suggest digoxin toxicity in an elderly patient?
Answer: Serum digoxin level of 2.5 ng/mL with nausea and bradycardia
A digoxin level above 2.0 ng/mL combined with symptoms like nausea and bradycardia is consistent with toxicity, especially in older adults.
Which opioid is considered INAPPROPRIATE for use in older adults due to toxic metabolite accumulation?
Answer: Meperidine
Meperidine accumulates normeperidine, a neurotoxic metabolite that can cause seizures, especially in patients with renal impairment common in the elderly.
A 78-year-old woman with a history of falls is prescribed a long-acting benzodiazepine for anxiety. What is the MTM pharmacist's most appropriate intervention?
Answer: Recommend switching to a short-acting agent or non-benzodiazepine anxiolytic
Long-acting benzodiazepines increase fall and fracture risk in older adults; transitioning to safer alternatives is recommended per Beers Criteria.
Which parameter best reflects kidney function for dosing purposes in older adults when using creatinine-based estimates?
Answer: Creatinine clearance estimated by Cockcroft-Gault using actual body weight
Cockcroft-Gault using actual body weight is most commonly used for drug dosing in older adults despite its limitations with very low muscle mass.
Which condition makes warfarin therapy particularly challenging to manage in older adults, increasing bleeding risk?
Answer: Polypharmacy with drug-drug interactions and variable dietary vitamin K
Polypharmacy and inconsistent dietary vitamin K intake in older adults cause INR fluctuations, significantly increasing the risk of over-anticoagulation and bleeding.
A geriatric patient is started on a statin. Which monitoring parameter is especially important in older adults?
Answer: Muscle symptoms and CK levels for myopathy
Older adults are at higher risk for statin-induced myopathy, so monitoring for muscle pain, weakness, and CK elevation is essential.
Which non-pharmacologic strategy should be integrated into the MTM care plan for an elderly patient with chronic insomnia before initiating hypnotics?
Answer: Cognitive behavioral therapy for insomnia (CBT-I)
CBT-I is the first-line treatment for chronic insomnia and is preferred over hypnotics in older adults due to safety concerns with sedatives.