Polypharmacy risk, Beers Criteria medications, and age-related pharmacokinetic changes tested on NCLEX-RN.
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- What is polypharmacy?
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The use of multiple medications, typically five or more, by one patient at the same time.- What is the primary risk associated with polypharmacy in older adults?
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Increased risk of adverse drug events and drug-drug interactions.- What organization publishes the Beers Criteria?
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The American Geriatrics Society.- What is the purpose of the Beers Criteria?
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To identify medications that are potentially inappropriate for use in older adults.- Why are benzodiazepines listed on the Beers Criteria for older adults?
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They increase the risk of falls, fractures, and cognitive impairment.- Which benzodiazepine duration is more strongly discouraged in older adults, short-acting or long-acting?
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Long-acting (for example, diazepam).- Why should first-generation antihistamines like diphenhydramine be avoided in older adults?
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They have strong anticholinergic effects that cause confusion, dry mouth, and urinary retention.- Name a common anticholinergic effect that can be mistaken for dementia in an older adult.
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Acute confusion or cognitive impairment.- Why are NSAIDs high-risk medications for older adults?
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They increase the risk of GI bleeding and kidney injury.- What is the "triple whammy" combination that raises acute kidney injury risk in older adults?
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An NSAID, an ACE inhibitor (or ARB), and a diuretic taken together.- Why is meperidine avoided in older adults?
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Its metabolite accumulates and can cause neurotoxicity, including seizures.- Why are skeletal muscle relaxants like cyclobenzaprine avoided in older adults?
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They cause sedation, anticholinergic effects, and increased fall risk.- What nursing principle guides medication dosing in older adults?
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Start low and go slow.- Why does gastric acid production tend to decrease with age?
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Age-related decline in parietal cell function reduces stomach acid, which can alter drug absorption.- How does aging typically affect body fat and lean muscle composition?
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Body fat increases while lean muscle mass decreases.
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