Deck 11: Polypharmacy

Question 1

Polypharmacy, like any other geriatric syndrome, can look on the surface like a specific disease state.

Answer 1

True

Question 2

The absence of a social group makes medication side effect difficult to differentiate from new medical problems because no one is present to witness the onset of a problem.

Answer 2

True

Question 3

Although the brown bag method is a time-consuming method of assessment, it should be performed at least annually with the results documented in the patient's chart because it is the gold standard for office assessment of medication use.

Answer 3

True

Question 4

The first medication in the era of modern medicine use was in the early 1900s when which of the following was discovered to be a universal pain reliever?

A) Morphine
B) Aspirin
C) Penicillin
D) Tetracycline

Question 5

Which of the following describes the practice of treating medication side effects with other medications?

A) Polypharmacy
B) Prescribing cascade
C) Extrapyramidal syndrome
D) Metabolic syndrome

Question 6

What medical condition is common in elders, even without diuretic therapy or beta-blocker use, because baroreceptors become less sensitive to change in posture and other compensatory systems are altered by frailty?

A) Essential hypertension
B) Malignant hypertension
C) Orthostatic hypotension
D) Neurally mediated hypotension

Question 7

Cholinesterase inhibitors are actually documented in the medical literature as increasing the risk of falls, which would be predictable when you know that these medications increase the levels of what neurotransmitter that can cause bradycardia?

A) Serotonin
B) Epinephrine
C) Acetylcholine
D) Dopamine

Question 8

What type of medications cause significant impairment in function and can accelerate progression of dementia, which results in increasingly less ability to participate in IADLs and ADLs?

A) Antidepressant medications
B) Antipsychotic medications
C) Anticholinergic medications
D) Antispasmodic medications

Question 9

What medical professional is the only member of the healthcare team that actually witness the patient's use and outcome of medications, at least in the institutional setting?

A) Nurse
B) Physician
C) Pharmacist
D) Medical assistant

Question 10

The purpose of which of the following is to identify drugs to avoid in older adults independent of diagnosis and considering diagnosis to reduce adverse drug reactions and improve medication selection and use in older adults?

A) Beers Criteria
B) START criteria
C) STOPP criteria
D) Black box warning

Question 11

A person's physiologic reserve is a strong determinant of his or her ability to tolerate medications and resist medication harm.

Question 12

Most medical literature commonly defines polypharmacy as the concomitant use of five medications, however, a particular number of drugs used at the same time does not always predict medication harm.

Question 13

The guidance on recommended medication use to treat chronic disease and medical problems is designed to demonstrate efficacy and rarely designed to tell how drugs will perform in the frail elder.

Question 14

What method of creatinine clearance estimation underestimates GFR in obese patients and overestimates GFR in underweight patients?

A) Modification of Diet in Renal Disease formula
B) Cockroft and Gault method
C) CKD-EPI formula
D) Mayo Quadratic formula

Question 15

Elders should have what levels assessed when working up the complaint of cognitive impairment?

A) Blood glucose
B) BUN/creatinine
C) Triglycerides
D) Thyroid stimulating hormone

Question 16

When medications known to cause electrolyte imbalances are being used, which of the following should be performed weekly for 2 to 3 weeks when starting therapy and periodically once stable on the new diuretic?

A) Urinalysis
B) BUN/creatinine
C) Basic metabolic panel
D) Complete metabolic panel

Question 17

A common source of drug toxicity in the elderly is impaired drug clearance by which organ(s)?

A) Liver
B) Kidneys
C) Pancreas
D) Large intestine

Question 18

Which of the following are perceived as a sign that people are growing old and dependent and therefore are commonly not reported to their family and physicians?

A) Falls
B) Memory lapses
C) Medication misadventures
D) Difficulty in performing ADLs

Question 19

Which of the following are the most comprehensive instruments for measuring health literacy?

A) The three-level HL Scale and the 3-brief SQs
B) The 3-brief SQs and the Single Item Literacy Screener (SLS)
C) The Mini-Mental State Examination and the three-level HL Scale
D) The Mini-Mental State Examination and the Single Item Literacy Screener

Question 20

Which of the following is a commonly overlooked aspect of assessment of medication-related problems (MRPs)?

A) Frailty
B) Literacy
C) Renal function
D) Swallowing status