Pa Poly Pharmacy

Question 1

Amiodarone and warfarin ade

Answer 1

Increased risk of bleed

Question 2

Erythromycin and _______ cause hypotension and prolonged qt interval

Answer 2

Verapamil

Question 3

Erythromycin and __________ cause ade of myopathy and Rhabdomyolysis

Answer 3

Simvastatin

Question 4

Fluoxetine and paroxetine and _______ increase risk of extra pyramidal effects

Answer 4

Risperidone

Question 5

Anticholinergic meds

Answer 5

Antihistamine, Doxylamine, diphenhydramine, meclizine, promethazine
Parkinson’s, benztropine
Tcas, amitriptyline, Doxepin,
Oxybutinin,
Atropine, opthalmicus

Question 6

NSAID risks

Answer 6

If impaired gfr ———-> increased overall risk
Can worsen hypertension

Question 7

What is med reconciliation

Answer 7

Assessment of proper use of medications
Identify meds which can cause ADR

Question 8

Med rec steps, questions to ask

Answer 8

Is the patient taking the med correctly
Food interaction
Ask about. Herbals
Dose and frequency assessment

Question 9

STOPP is what

Answer 9

Screening tools of older person prescription

Question 10

Stopp utilized how

Answer 10

Identifies two med that are similar, and same therapeutic effects
Drug disease interaction, risk of meds are highlighted which can make conditions worse
Drug to drug interaction, combos that increase adverse events
Duration of therapy, identifies prolonged use and whether it is needed.

Question 11

Stop example

Answer 11

Beta blocker and verapamil, heart block risk
Aspirin and cardiovascular disease, no evidence of benefit
PPI greater than 8 weeks

Question 12

Start what is included

Answer 12

Preventative med, statins, or Antiplatelet
Essential treatment with evidence based
Condition specific meds, for illnesses

Question 13

Start examples

Answer 13

Beta blocker for coronary artery disease
Vaccines
Vitamin d for osteoporosis
Tiotropium or formoterol for COPD

Question 14

Beers criteria what is it used for and who

Answer 14

> 65
Identify inappropriate medications

Question 15

Beers criteria is assessing what

Answer 15

Drug category
Drugs to use with caution
Drug to drug interactions
Drugs to avoid with kidney impairment
Drugs with Anticholinergic properties

Question 16

Beers criteria med use with caution

Answer 16

Dabigatran for a fib increased gi bleed compared to Apixaban
Prasugrel and ticagrelor increase risk of bleed among those 75 and older, compared to clopidogrel

Question 17

Beers avoid use of what

Answer 17

Warfarin for non valvular Afib or VTE will increase bleed
Aspirin for prevention
NSAID if cr clearance less than 30: kidney injury potential
Oral estrogen———- stroke/ clot risks

Sulfonylureas, hypoglycemia

Question 18

Avoid what meds do to fall risk

Answer 18

Avoid benzos
Antidepressants
Opioid
Antiepileptics
Antipsychotic

Question 19

Drug interactions beers

Answer 19

Opioid and benzos
Opioid and gabapentin or Pregabalin

Question 20

Safer meds

Answer 20

Antihistamine, use Intranasal saline and non sedating antihistamine, certirizine, zrytec
Opioids, use acetaminophen, lidocaine patches, and capsaicin,
Anxiety, use buspar,
Antihyperglycemia, metformin if necessary
Non valv afib, Apixaban

Question 21

Recommendation to improve communication in elders

Answer 21

Assess cognition first
Speak slow and clear
Look directly at the patient when speaking
Include family
Plain language
Use visual aid

Question 22

What is polypharmcayc

Answer 22

Over utilization and inappropriate use of medications

Question 23

Med with long half life,
Digoxin _____ hours
Lithium, __ hours
Warfarin is ___ hours

Answer 23

38
Lithium, is 36
Warfarin is 20-60

Question 24

Patient with dry mouth, constipation and blurry vision

Answer 24

Diphenhydramine. Benadryl
Amitriptyline, nortriptyline

Question 25

Ssri vs tricyclic antidepressants

Answer 25

Ssri best, vs Tcas, have to address depression but Tcas big risk for confusion, retention

Question 26

What can nsaid do what to look for

Answer 26

HTN Gi bleed Impairs mucosal repair

Question 27

Prevent adverse reaction

Answer 27

Start at lowest effective dose

Question 28

Pt presents with hypertension what to assess first

Answer 28

Is their hypertension do to NSAIDs

Question 30

What meds to be lowered due to high first pass

Answer 30

Metoprolol, diazepam, morphine, and verapamil