III: Pediatric and Geriatric Pharmacology

Question 1

_____: adherence to clinical practice guidelines in caring for geriatric patients with multiple comorbidities may have undesired effects

Answer 1

Parsimony

Question 2

_____: failure to account for impact of multiple chronic diseases on medication safety and efficacy

Answer 2

Danger of silo thinking

Question 3

Absolute Risk Reduction (ARR) =

Answer 3

Incidence of Control - Incidence of Treated

Question 4

Cockroft-Gault Equation: _________

Answer 4

(Weight(140-Age))0.85/(72*Cr)

Question 5

Drugs undergoing _____ metabolism are preferred in older patients

Answer 5

Phase II

Question 6

For older patients, the ____ dose needs to be decreased for hydrophilic drugs.

Answer 6

loading

Question 7

For older patients, the ____ dose needs to be decreased for renally excreted drugs.

Answer 7

maintenance

Question 8

For older patients, the ____ dose needs to be increased for lipophilic drugs.

Answer 8

loading

Question 9

For older patients, the loading dose needs to be decreased for ______ drugs

Answer 9

hydrophilic

Question 10

For older patients, the loading dose needs to be increased for ______ drugs

Answer 10

lipophilic

Question 11

For older patients, the maintenance dose needs to be decreased for ______ drugs

Answer 11

Phase I metabolism or renally excreted

Question 12

In children, drugs often require ______ maintenance doses compared to adults

Answer 12

increased

Question 13

In older patients, _____ gastric acid production leads to _____ absorption of weak acid drugs and _____ absorption of weak base drugs.

Answer 13

decreased; decreased; increased

Question 14

In older patients, drug rate of excretion _____.

Answer 14

decreases

Question 15

In older patients, extent of drug absorption ______.

Answer 15

does not change

Question 16

In older patients, Phase __ reactions are preferentially decreased in hepatic drug metabolism

Answer 16

I

Question 17

In older patients, volume of distribution ______ for hydrophilic drugs

Answer 17

decreases

Question 18

In older patients, volume of distribution ______ for lipophilic drugs

Answer 18

increases

Question 19

Initiation of hypertension may increase risk of _____.

Answer 19

falls

Question 20

Name two medications that do not impair cognition.

Answer 20

docusate, acetaminophen

Question 21

Number Needed to Treat (NTT) =

Answer 21

100/ARR

Question 22

Relative Risk Reduction (RRR) =

Answer 22

(Incidence of Control - Incidence of Treated)/Incidence of Control

Question 23

Renal excretion is more predictable in ______.

Answer 23

children

Question 24

Which drug (class)? May exacerbate arthralgia/myalgia/osteoporosis (4)

Answer 24

Glucocorticoids, phenytoin, heparin, Vitamin D

Question 25

Which drug (class)? May exacerbate constipation (4)

Answer 25

CCBs, opioids, antihistamines, antimuscarinic

Question 26

Which drug (class)? May exacerbate hypotension (5)

Answer 26

beta-blockers, CCBs, vasodilators, diuretics, antidepressants

Question 27

Which drug (class)? May exacerbate movement disorders (2)

Answer 27

anti-psychotics, metoclopramide

Question 28

Which drug (class)? May exacerbate overflow incontinence (6)

Answer 28

anticholinergics, antihistamines, TCAs, anti-psychotics, smooth muscle relaxants, alpha antagonists

Question 29

Which drug (class)? May exacerbate psychomotor retardation (4)

Answer 29

benzodiazepines, antihistamines, anti-psychotics, antidepressants

Question 30

Which drug (class)? May exacerbate risk of falls (2)

Answer 30

Benzodiazepines, TCAs

Question 31

Which drug (class)? May exacerbate stress incontinence (1)

Answer 31

alpha-antagonists

Question 32

Which drug (class)? May exacerbate tinnitus/vitiligo (3)

Answer 32

aminoglycosides, aspirin, ethacrynic acid

Question 33

Which drug (class)? May exacerbate urge incontinence (2)

Answer 33

cholinergic agonists, diuretics

Question 34

Which drug class carries the following risks in children? Inhibition of growth via pituitary GH suppression (loss of half an inch)

Answer 34

Glucocorticoids

Question 35

Which drug class carries the following risks in children? May cause hepatic dysfunction and Reyes Syndrome

Answer 35

Aspirin

Question 36

Which drug class carries the following risks in children? Modest effect on growth secondary to appetite suppression with weight loss/sleep disturbance

Answer 36

CNS stimulants

Question 37

Which drug class carries the following risks in children? Permanent staining of teeth; contraindicated for children younger than age 8-9

Answer 37

Tetracyclines

Question 38

Which drugs should be withdrawn with care?

Answer 38

Clonidine, Amitriptyline

Question 39

Which statistical parameter is most important in tailoring treatment decisions?

Answer 39

Number Needed to Treat