Deck 27: Drugs and Older Adults

Question 1

Match each term to the definition listed below.
Delivery of a substance from the bloodstream into tissues and fluids of body

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Answer 1

Distribution

Question 2

Match each term to the definition listed below.
Circulatory dysfunction, less muscle mass, and increased fat

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Answer 2

Absorption

Question 3

Match each item with the correct statement below.
End result is a list of all medications taken including indications and how to administer.

A)Polypharmacy
B)BEERs list drugs
C)Medication-related problems (MRPs)
D)Comprehensive medication review (CMR)
E)Medication Therapy Management (MTM)

Answer 3

Comprehensive medication review (CMR)

Question 4

Match each term to the definition listed below.
Hepatic dysfunction

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 5

Match each term to the definition listed below.
Lack of or decreased stomach acid production, use of PPIs and antacids

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 6

Match the following medications with the reason they may be considered inappropriate for adults over 65 years of age.
Cardiac glycosides (digoxin)

A)Cognitive impairment, fall risks
B)GI bleeding, increased cardiovascular risks
C)Orthostatic hypotension, tachycardia
D)May lower seizure threshold
E)Breast and endometrial cancer
F)Multiple drug interactions, decreases absorption of other medications
G)Toxicity due to renal clearance
H)Increased blood pressure

Question 7

Match each term to the definition listed below.
decreased GI motility, decreased fluid intake

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 8

Match each item with the correct statement below.
Becoming common practice in pharmacies, some insurers are compensating for this patient safety practice.

A)Polypharmacy
B)BEERs list drugs
C)Medication-related problems (MRPs)
D)Comprehensive medication review (CMR)
E)Medication Therapy Management (MTM)

Question 9

Match each term to the definition listed below.
Passage of a substance through a membrane into the bloodstream

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 10

Match the following medications with the reason they may be considered inappropriate for adults over 65 years of age.
NSAIDs

A)Cognitive impairment, fall risks
B)GI bleeding, increased cardiovascular risks
C)Orthostatic hypotension, tachycardia
D)May lower seizure threshold
E)Breast and endometrial cancer
F)Multiple drug interactions, decreases absorption of other medications
G)Toxicity due to renal clearance
H)Increased blood pressure

Question 11

Match each item with the correct statement below.
May be mistaken for normal signs of aging, in 2012 reported estimate of 100,000 deaths per year were caused by these.

A)Polypharmacy
B)BEERs list drugs
C)Medication-related problems (MRPs)
D)Comprehensive medication review (CMR)
E)Medication Therapy Management (MTM)

Question 12

Match each term to the definition listed below.
Physical and chemical alterations the substance undergoes in the body (biotransformation)

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 13

Match each term to the definition listed below.
Increased effect of a drug that results from its accumulation in the body

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 14

Match each item with the correct statement below.
Taking multiple drugs, prescription, OTC or herbal, for multiple conditions.

A)Polypharmacy
B)BEERs list drugs
C)Medication-related problems (MRPs)
D)Comprehensive medication review (CMR)
E)Medication Therapy Management (MTM)

Question 15

Match the following medications with the reason they may be considered inappropriate for adults over 65 years of age.
Alpha-blockers

A)Cognitive impairment, fall risks
B)GI bleeding, increased cardiovascular risks
C)Orthostatic hypotension, tachycardia
D)May lower seizure threshold
E)Breast and endometrial cancer
F)Multiple drug interactions, decreases absorption of other medications
G)Toxicity due to renal clearance
H)Increased blood pressure

Question 16

Match each item with the correct statement below.
List of PIMs (potentially inappropriate medications) for nursing home residents based on a national survey of geriatric experts, most recently updated in 2015.

A)Polypharmacy
B)BEERs list drugs
C)Medication-related problems (MRPs)
D)Comprehensive medication review (CMR)
E)Medication Therapy Management (MTM)

Question 17

Match each term to the definition listed below.
Excessive use of drugs or prescriptions or many drugs given at one time

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 18

Match each term to the definition listed below.
Renal dysfunction, constipation or poor gas exchange in lungs

A)Absorption
B)Cumulative effect
C)Distribution
D)Metabolism
E)excretion

Question 19

MRPs or medication-related problems may be mistaken for which problem?

A) A normal consequence of aging
B) Behavioral changes
C) Cognitive impairment
D) Parkinsons

Question 20

A notable increase in serious complications resulting from adverse drug reactions is said to be related to _________.

A) increased life span leading to an increased older adult population
B) increased abuse of prescription drugs by the elderly
C) people taking fewer but stronger medications
D) subdued responses to medications

Question 21

Excretion is the primary role of which organ/system?

A) Circulatory
B) Hepatic
C) Cardiovascular
D) Renal

Question 22

Metabolism is primarily affected by which organ/system?

A) Renal
B) Circulatory
C) Hepatic
D) Respiratory

Question 23

Prescribing of medications is the third leading intervention experienced by older adult patients.

Question 24

An increase of falls is seen in older adults taking which group of medications?

A) Antidepressants
B) Anticonvulsants
C) Long-acting benzodiazepines
D) All of the above.

Question 25

Which of the following are potential side effects of NSAIDs in older adults?

A) Prolonged bleeding time
B) Silent bleeding ulcer
C) Hypertension
D) Increased cardiovascular risks

Question 26

To help prevent medication errors in older patients, they should _______.

A) be provided medications by the pharmacist in child-resistant containers
B) be encouraged to see their physician only when they experience a side effect of a medication
C) be advised to stop any medication as soon as signs of side effects occur
D) make a list of all medications and carry it in their wallet at all times

Question 27

Which statement best describes polypharmacy?

A) Using more than five drugs at a time
B) Using more than two drugs at a time
C) Using multiple drugs for multiple conditions
D) Going to multiple pharmacies

Question 28

Distribution in older adults is affected by all of the following, EXCEPT ______.

A) decreased albumin production by the liver
B) circulatory compromise
C) decrease in total body water
D) decreased renal function

Question 29

What would be the most appropriate intervention with regard to medication administration in the older adult who has an impaired circulatory process?

A) Start at the lowest dose possible and increase the dose gradually.
B) Increase the frequency of dosing.
C) Monitor the patient frequently.
D) All of the above.

Question 30

All of the following are bodily processes that affect drugs, EXCEPT ________.

A) absorption
B) distribution
C) metabolism
D) cognition

Question 31

Many of the Beers list drugs exhibit what type of properties that older adults are more likely to have adverse reactions to?

A) Adrenergic
B) Anticholinergic
C) Sympathomimetic
D) Anti-inflammatory

Question 32

What aging processes affect the functionality of the liver?

A) Decrease in blood flow to the liver
B) Decreased glomerular filtration
C) Decreased GI motility
D) Decreased body water
E) All of the above.

Question 33

Omeprazole and cimetidine should be avoided in some older patients due to which of the following?

A) They are long-acting benzodiazepines.
B) They inhibit liver enzymes from breaking down long-acting benzodiazepines.
C) They inhibit liver enzymes from breaking down short-acting benzodiazepines.
D) They result in decreased absorption of medications.

Question 34

Impaired distribution of drugs in older adults is most likely related to _______.

A) hepatic dysfunction
B) poor gas exchange
C) inadequate circulatory function and decreased muscle mass
D) slowed GI motility and reduced fluid intake

Question 35

Impaired excretion in older adults results from all of the following, EXCEPT _______.

A) decrease in glomerular filtration
B) increased kidney size
C) decreased renal blood flow
D) diabetes

Question 36

The Beers List Drugs refers to ________.

A) inappropriate drugs used in hospitalized, young adults
B) most commonly abused prescriptions in older adults
C) medications that should not be used in those who are cognitively impaired
D) inappropriate drugs used in the ambulatory elderly population

Question 37

Hepatic dysfunction more likely affects ________.

A) absorption
B) metabolism
C) distribution
D) excretion

Question 38

Absorption of medications may be affected by which of the following?

A) Aging, thinner skin
B) Decrease in muscle mass
C) Decreased gastric motility
D) All of the above.
E) None of the above.

Question 39

Medication-related problems may be easily mistaken for a normal consequence of aging or a progression of an existing disease.

Question 40

Which of the following best describes how absorption is affected in the GI tract?

A) Increased food intake in the elderly slows gastric emptying.
B) Gastric acid production is diminished in the elderly.
C) Older patient's sometimes refuse to use antacids.
D) Increased gastric motility in the elderly does not allow for absorption of the medication.

Question 41

In older adults, cognitive impairment is rarely the result of drug therapy.

Question 42

NSAIDS carry real danger of serious complications.

Question 43

As a result of the aging process, the liver produces more albumin allowing more unbound drug to reach receptor sites.

Question 44

Medication Therapy Management (MTM) and Comprehensive Medication Review (CMR) may be compensated to pharmacies by some insurance companies to improve patient safety.

Question 45

Weekly pillboxes, unit dose packs, and pillbox alarms have proven unhelpful in lessening medication errors or increasing adherence.

Question 46

Polypharmacy is only a problem if there are negative outcomes or adverse events.

Question 47

If a patient has taken a drug for many years, the same dose is considered to be safe and effective as he grows older because he will have built a tolerance for it.

Question 48

Thinning skin associated with the aging process may impair absorption of transdermal medications.

Question 49

Polypharmacy refers to pharmacy shopping by patients.

Question 50

Drugs may be more or less effective in pediatric patients, much like in older adults, so doses must be carefully calculated and effectiveness monitored.

Question 51

The health care professional should never question potentially inappropriate medicines or dosages once the doctor has written the order.

Question 52

Nonadherence is most common in older adults, for a variety of reasons.

Question 53

The liver is a major site of drug metabolism.

Question 54

One way to avoid serious side effects associated with polypharmacy is to request the physician to substitute a medication or do a CMR.