Deck 3: Geriatric Pharmacology

Question 1

Harry,a 70-year-old,and Ben,a 28-year-old,are taking the same dose of a certain drug that needs to undergo oxidation in their bodies.How will the drug metabolism in Harry's body differ from that in Ben's body?

A) The rate at which the drug will be metabolized in Harry's body will be much faster than the rate at which it will be metabolized in Ben's body.
B) A greater amount of the drug will be absorbed by Ben's body than it will be absorbed by Harry's body.
C) The duration of drug action in Ben's body will be longer than the duration of drug action in Harry's body.
D) The pharmacological effects of the drug will be experienced for a longer duration of time in Harry's body than they will be experienced in Ben's body.

Answer 1

The pharmacological effects of the drug will be experienced for a longer duration of time in Harry's body than they will be experienced in Ben's body.

Question 2

Arthur,a 70-year-old,and Kevin,a 24-year-old,are given the same dose of a certain water-soluble drug X.When Dr.Robinson examines samples of their blood plasma,he finds that the concentration of X in Arthur's system is much higher than the concentration of X in Kevin's system.Why is Arthur's blood plasma more concentrated with drug X than Kevin's blood plasma?

A) Because elderly people have a lower percentage of total body water than younger people do
B) Because elderly people have more lean body mass than younger people do
C) Because elderly people have less adipose tissue than younger people do
D) Because elderly people have less intestinal absorptive surface area than younger people do

Answer 2

Because elderly people have a lower percentage of total body water than younger people do

Question 3

A decrease in renal function is associated with:

A) an increase in the rate of drug excretion.
B) an increase in the duration of the drug action.
C) a decrease in the intensity of the drug action.
D) a decrease in the rate of drug metabolism.

Answer 3

an increase in the duration of the drug action.

Question 4

Which of the following age-related changes is responsible for the decrease in the rate of drug metabolism in elderly patients?

A) The increase in the production of drug microsomal metabolizing enzymes
B) The reduction in renal blood flow
C) The decrease in liver blood flow
D) The increase in the concentration of plasma proteins

Question 5

Equal doses of a certain fat-soluble drug are administered to two individuals,John,who is 20 years old and Eric,who is 70 years old.Which of the following is most likely to happen based on the information provided in this scenario?

A) A greater percentage of the drug in John's body will get diverted away from the liver and kidneys than the percentage of the drug in Eric's body.
B) Eric's body will be able to eliminate the drug much faster than John's body will be able to eliminate it.
C) The drug will get more widely distributed to various organs in John's body than it will get distributed to the organs in Eric's body.
D) The drug will have a longer half-life in Eric's body than it will have in John's body.

Question 6

Ken,a 60-year-old,has been taking daily doses of certain fat-soluble drugs.Identify an accurate statement about how these drugs will get distributed in Ken's body.

A) Most of the drugs will dissolve into the body fluids.
B) The drugs will be distributed to the body organs that have a high content of adipose tissue.
C) The drugs will be directly diverted to the liver and kidneys.
D) Most of the drugs will dissolve into the blood plasma.

Question 7

Why do fat-soluble drugs have a longer half-life and duration of action in the elderly?

A) Because they get diverted away from the liver and kidneys
B) Because they dissolve faster in the fluids of the body
C) Because they are less widely distributed to the other organs in the body
D) Because they are instantly metabolized as soon as they are ingested

Question 8

Which of the following pharmacokinetic processes is most affected by the reduction of renal blood flow with age?

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

Question 9

The drug morphine has a high first-pass metabolism.What change in the dosage of morphine would have to be made if the drug were to be administered to an elderly patient?

A) A higher dose of morphine should be administered.
B) The same dose of morphine that would be administered to a younger patient should be administered.
C) The drug morphine should not be administered to a patient above the age of 60.
D) A lower dose of morphine should be administered.

Question 10

Who among the following is most likely to have the lowest rate of drug metabolism?

A) 62-year-old Edward, whose liver is showing symptoms of poor blood circulation
B) 30-year-old Estella, who is following a protein-rich diet
C) 21-year-old Fabiola, who often consumes alcohol when she goes out
D) 60-year-old John, who smokes occasionally

Question 11

Which of the following changes takes place as a person ages?

A) The amount of blood pumped by the heart per minute increases.
B) The size of several body organs decreases.
C) The frequency and nature of adverse reactions to drugs decreases.
D) The efficiency with which the liver metabolizes drugs increases.

Question 12

The enzymes that are most affected by the process of aging are those that play a role in _____ drugs.

A) oxidizing
B) reducing
C) chelating
D) alkylating

Question 13

In comparison to the members of other age groups,members of the geriatric population are:

A) less likely to consume drugs.
B) more likely to experience the adverse effects of a drug.
C) less likely to suffer from toxicity.
D) more likely to benefit from the therapeutic effects of the drug.

Question 14

Which of the following may contribute to drug toxicity in the geriatric population?

A) Increased activity of liver enzymes
B) Stable creatinine levels
C) Reduced production of plasma proteins
D) Leukopenia

Question 15

Identify an accurate statement about the use of drugs in the elderly.

A) Elderly people tend to use less drugs than people in other age groups.
B) Elderly people are less likely than people from other age groups to experience adverse drug reactions.
C) Compared to people from other age groups, elderly people account for the highest percentage of drug prescriptions per year.
D) Compared to people from other age groups, elderly people are more able to eliminate drugs from their bodies.

Question 16

How would John,an elderly patient who smokes and consumes alcohol,tolerate an adult-strength dose of actively oxidized medication in comparison to Rick,an elderly patient who neither smokes nor drinks?

A) John would not be able to metabolize the drug, whereas Rick would be able to metabolize it.
B) Rick would be able to metabolize the drug in the same amount of time as John would be able to metabolize it.
C) John would be able to metabolize the drug at a faster rate than Rick would be able to metabolize it.
D) Rick's body would absorb a lesser amount of the drug than John's body would absorb.

Question 17

Drugs are mainly eliminated from the body by _____.

A) sweating
B) renal excretion
C) enterohepatic recycling
D) regurgitation

Question 18

An elderly man has been taking an adult-strength dose of the topical steroid hydrocortisone for the past four weeks.He has developed thin skin and stria along his back,which are physical indications of toxicity.Which of the following might have led to the toxic effects of the steroid?

A) A reduction in the amount of the drug absorbed by the intestine
B) A buildup of the drug in the adipose tissues
C) An increase in the metabolic activity of the liver
D) An increase in the rate at which the drug is excreted by the kidneys

Question 19

Which of the following changes in aging people tends to slow down the rate of drug absorption and the onset of drug action?

A) A decrease in the amount of gastric acid secreted
B) An increase in intestinal motility
C) An increase in blood flow to the intestinal tract
D) A decrease in the percentage of adipose tissue in the body

Question 20

Dr.Hampton administers the same dose of a certain water-soluble drug to two of his patients,Nathaniel,who is 65 years of age,and Mark,who is 25 years of age.Which of the following is most likely going to happen?

A) Most of the drug in Nathaniel's body will get deposited in the body organs that have a high fat content, away from the liver and kidneys.
B) The drug will be more widely distributed in Nathaniel's body than it will be in Mark's body.
C) Nathaniel will experience a more intense pharmacological drug effect than Mark will experience.
D) The concentration of the drug in Mark's blood plasma will be higher than the concentration of the drug in Nathaniel's blood plasma.

Question 21

Who among the following is most likely to experience an impaired drug response caused by the lack of adequate nutrition?

A) A comatose patient on TPN
B) A patient living with his or her family members
C) A nursing home patient
D) A physically active senior citizen

Question 22

Lack of adequate protein intake in elderly people:

A) leads to a lower concentration of plasma proteins.
B) leads to an increase in the synthesis of drug metabolizing enzymes.
C) leads to an increase in the rate of drug metabolism.
D) leads to a decrease in the intensity of drug action.

Question 23

An elderly patient was on medication for diabetes and hypertension before suffering a heart attack.Her cardiologist gave her thorough directions on taking her new heart medications.What would be a probable outcome of this situation?

A) No change in patient compliance
B) A slight improvement in patient compliance
C) A substantial increase in patient compliance
D) A decrease in patient compliance

Question 24

A decrease in the size of the liver is directly associated with a(n):

A) increase in the rate of drug absorption.
B) decrease in the rate of drug excretion.
C) increase in the rate at which the drug is distributed through the body.
D) decrease in the rate of drug metabolism.

Question 25

One approach that can be used to facilitate decisions and enhance compliance when explaining medications to an elderly patient is to:

A) provide current pharmaceutical literature.
B) speak loudly.
C) use proper medical terminology.
D) display appropriate demeanor.

Question 26

How would one expect the plasma creatinine levels in a person's body to change with age?

A) Slightly decrease with age
B) Remain unchanged
C) Dramatically decrease with age
D) Increase with age

Question 27

Which of the following factors can affect drug metabolism by reducing the efficiency with which organs function?

A) Genetics
B) Nutritional deficiency
C) Disease
D) All of these

Question 28

Which of the following proteins plays an important role in plasma protein drug binding?

A) Albumin
B) Myoglobin
C) Hemoglobin
D) Myosin

Question 29

A patient having multiple chronic diseases can expect:

A) an increase in the consequences of a drug's action.
B) a decrease in the consequences of a drug's action.
C) no change in the consequences of a drug's action.
D) all of these.

Question 30

In relation to their medications,why is it important for elderly patients to increase their dietary protein intake?

A) To maintain appropriate albumin levels
B) To increase serum potassium levels
C) To lower serum triglyceride levels
D) To maintain serum calcium levels

Question 31

Which of the following would most likely be a chief complaint from elderly patients taking omeprazole capsules?

A) Dosing frequency
B) Dietary restrictions
C) Difficulty swallowing
D) Small size

Question 32

One way to improve compliance for a patient with arthritis would be to:

A) encourage the patient to take medication on an empty stomach.
B) suggest not using child safety caps on medication bottles.
C) encourage the patient to read medication information literature.
D) allow the patient to identify the drugs he requires on his own.

Question 33

Adequate nutrition in elderly patients is important for synthesizing drug-metabolizing enzymes.The body produces these enzymes from foods that are high in:

A) fat.
B) protein.
C) carbohydrate.
D) sugar.

Question 34

The term used to describe the situation that involves multiple drug prescriptions is _____.

A) pharmacotherapy
B) polypharmacy
C) therapeutic duplication
D) monotherapy

Question 35

Which of the following physiological changes in an elderly patient lowers the rate of drug metabolism?

A) An increase in the flow of blood to the liver
B) A decrease in the production of enzymes that oxidize drugs
C) An increase in renal blood flow
D) A decrease in the percentage of adipose tissue in the body