Geriatrics

Question 1

Widely used phenotype for frailty

Answer 1

> 3 of the following criteria. Weight loss, exhaustion, weak grip strength, slow walking speed and low physical activity

Question 2

Serum creatinine not used to measure kidney function in elders why?

Answer 2

Less muscle mass so less creatinine in circulation

Question 3

Function of Cockcroft-Gault

Answer 3

Calculate creatinine clearance

Question 4

Possibilities of anticholinergic effects

Answer 4

addiction, abuse, respiratory depression and confusion

Question 5

Elderly use of Benzodiazepines

Answer 5

Anxiety use and one should use short acting

Question 6

Examples of Benzodiazepines to use with elders

Answer 6

Alprazolam, Temazepam, and Lorazepam

Question 7

Withdrawal symptoms of Benzodiazepines

Answer 7

Rebound Insomnia and falls

Question 8

Strong anticholinergic and sedative Antidepressant to avoid in elderly ( TCA)

Answer 8

Amitriptyline

Question 9

SSRIs better than TCA for elderly because

Answer 9

Low cardiotoxicity, orthostatic hypotension and anticholinergic. E.g are Citalopram, Escitalopram

Question 10

What antiarrhythmic drug is contraindicated with the elderly and why?

Answer 10

Disopyrmide - anticholinergic properties, glaucoma, urine retention, increased HR, heart block and heart failure( potentially inappropriate medication)

Question 11

Hypoglycemia effect on elderly

Answer 11

Insulin

Question 12

GI and intracranial bleeding in elderly

Answer 12

Warfarin

Question 13

Heart Block, impaired cognition

Answer 13

Digoxin

Question 14

33% of ED ADE in elderly due to

Answer 14

insulin, digoxin and warfarin

Question 15

Goals of Care of elderly drugs

Answer 15

Centralization and reappraisal of need to use some drugs and its duration

Question 16

MASTER is pneumonic for model on safe and effective prescribing - what does MASTER mean?

Answer 16

Minimize, Alternatives, Start low, go slow,Titrate, Educate and Review regularly