Midterm: DSA: Concepts in Geriactrics and Geriatric Pharm

Question 1

What are the categories of elderly?

Answer 1

Young Old: 65-75
Old-Old: 75-85
Very Old: 85+

Question 2

What does the USPSTF recommend to reduce fall risks in elderly?

Answer 2

Exercise or physical therapy and vitamin D supplementation in those 65+

Question 3

What are the three exams used to test for cognitive decline?

Answer 3

MoCA-Montreal Cognitive Assessment
MMSE-MiniMental Status Exam
MiniCOG: three words plus clock drawing test

Question 4

In an elderly patient with a MiniCOG is positive, what can you do next?

Answer 4

do a full MMSE or MoCA

Consider full Neuropsychiatric Evaluation

Question 5

Besides memory defects, what other defect may mimic cognitive decline?

Answer 5

Sensory or behavioral defects

Also look for organic cause

Question 6

Sleep disturbances, fatigue, psychomotor issues, and hopelessness about the future are signs of what in the elderly?

Answer 6

Depression

Question 7

What is a good solution for bladder and bowel issues in patients that it is more of a mobility issue rather than loss of bladder control?

Answer 7

Go to the bathroom at regular times,
exercise to optimize mobility,
pelvic floor exercises

Question 8

whats the rule of thumb for meds in the elderly?

Answer 8

Start at lowest dosages and slowly increase if you must

Question 9

What drug choices should be used with caution?

Answer 9

Direct Oral anticoagunlants (bleeds)
Warfarin (bleeds)
Tramadol (CNS issues)
Antipsychotics in PD (dyskinesias)

Question 10

What does polypharmacy (pt on multiple drugs) increase the risk of?

Answer 10

Drug cascades

-the prescribing of one drug to offset the adverse the effects of another

Question 11

What is the most commonly used criteria in the elderly?

Answer 11

BEER’S

-talks about which drugs could be unsafe for elderly

Question 12

What is a Direct Power of Attorney (DPOA) used for?

Answer 12

Puts decision making into the hands of another person if the individual is unable to
-Can be different for health, business, and financial!!

Question 13

What is an advanced directive?

Answer 13

Indicates what treatments patient does/doesn’t want

• code status
• incubate/ventilator
• tube feeding
• etc

Question 14

What medication should be avoided with opioids?

Answer 14

Benzos

-increase OD risk

Question 15

What meds should be used with caution when pt on ACE/ARBs?

Answer 15

Sulfa drugs

TMP-SMX, etc

Question 16

Which drugs should be avoided in pts with delirium?

Answer 16

H2 antagonists

Question 17

Why should aspirin be used with caution when pt is 70+?

Answer 17

Increases risks of bleeding

Question 18

What meds should you avoid if pt has history of falls?

Answer 18

SNRIs