Geriatrics

Question 1

sulfonylureas consideration (Beers Criteria)

Answer 1

-higher risk of CV events & all cause mortality
-higher risk of hypoglycemia
-MAY increase risk of ischemic stroke & CV death
-use short-term over long-term (glipizide over glyburide)

Question 2

Insulin sliding scale considerations (Beers Criteria)

Answer 2

-higher risk of hypoglycemia
-if using bolus use basal insulin as well

Question 3

Physiologic changes in geriatrics

Answer 3

-DECREASE TBW, lean body mass, baroreceptor response/activity, heart rate variability, hepatic blood flow, neurotransmitter volume
-INCREASE body fat

Question 4

decrease in VD

Answer 4

increase in concentration of water-soluble drugs
-atenolol

Question 5

increase in VD

Answer 5

increase in half-life of lipid-soluble drugs
-rifampin

Question 6

decrease clearance

Answer 6

increase in half-life of hepatically & renally cleared drugs
-propranolol & atenolol

Question 7

AE of anticholinergic/antimuscarinics

Answer 7

-dry mouth, constipation, confusion

Question 8

anticholinergic/antimuscarinic medications

Answer 8

-oxybutynin (Ditropan, Oxytrol, Gelnique)

Question 9

B3 agonist medications

Answer 9

-mirabegron (Mybetriq); Vibegron (Gemtesta)

Question 10

B3 agonist AE’s

Answer 10

minor increase in BP, UTI