Nursing 306 - Older Adults and Pharmacology Test Questions with Correct Answers Graded A+
Pharmacokinetics - Answers Movement of drug in body from administration to excretion.
Changes in absorption with age - Answers Increased gastric pH, decreased absorbic surface, decreased
splanchnic blood flow, decreased GI activity. Effects on EC meds.
Changes in distribution with age - Answers Decreased cardiac output, decreased total body water,
decreased lean body mass, increased body fat, decreased serum albumin, decreased protein binding.
Effects on fat soluble meds (benzodiazepines, phenobarbital, haloperidol), protein-bound meds
(levothyroxine, Dilantin, warfarin), water soluble drugs (lithium, digoxin, alcohol, aminoglycosides).
Changes in metabolism with age - Answers Decreased liver activity, mass, volume, and blood flow.
Decreased hepatic clearance. Increased half-life of meds, need to adjust dosage/timing (max of 3g
acetaminophen in 24 hours). Effects on NSAIDs, morphine, amlodipine, diltiazem, verapamil, levodopa,
alprazolam, diazepam, trazodone.
Changes in elimination with age - Answers Decreased renal blood flow, decreased GFR, decreased
secretory function. Increased half-life of meds. Effects on cipro, macrobid, captopril, digoxin, enalapril,
lisinopril, furosemide, hydrochlorothiazide, glyburide, ranitidine, risperidone.
Pharmacodynamics - Answers Interaction between drug and body. Response at action site, side effects,
toxicity.
Pharmacodynamics age-related changes - Answers Decreased response to beta-adrenergic receptor
stimulators/blockers, decreased baroreceptor sensitivity, increased sensitivity to medications
(anticholinergics, benzodiazepines, narcotics, warfarin, diltiazem, verapamil).
Polypharmacy - Answers Concomitant administration of 5+ drugs contributes to an increase in adverse
effects & dangerous drug interactions, and decreases medication compliance.
ER visits - Answers Problems associated with anticoagulants (warfarin/Coumadin), antiplatelet drugs,
hypoglycemic agents, digoxin, insulin. Seen for GI bleeding, falls, delirium.
Toxicity factors - Answers Regular use (daily, prn), interactions (food, meds), long half life, disease
(kidney, liver), confusion.
Nursing role - Answers Know action & side effects, educate patient & family, check medications if any
changes occur.
OTC med safety - Answers Not safe just because they are available OTC, still need to report to provider.
May delay treatment by providing relief without addressing problem, use meds inappropriately,
interactions between meds. NSAIDs cause ulcers, interact with anticoagulants, ginseng; antihistamines
cause dehydration & sedation.
Pharmacokinetics - Answers Movement of drug in body from administration to excretion.
Changes in absorption with age - Answers Increased gastric pH, decreased absorbic surface, decreased
splanchnic blood flow, decreased GI activity. Effects on EC meds.
Changes in distribution with age - Answers Decreased cardiac output, decreased total body water,
decreased lean body mass, increased body fat, decreased serum albumin, decreased protein binding.
Effects on fat soluble meds (benzodiazepines, phenobarbital, haloperidol), protein-bound meds
(levothyroxine, Dilantin, warfarin), water soluble drugs (lithium, digoxin, alcohol, aminoglycosides).
Changes in metabolism with age - Answers Decreased liver activity, mass, volume, and blood flow.
Decreased hepatic clearance. Increased half-life of meds, need to adjust dosage/timing (max of 3g
acetaminophen in 24 hours). Effects on NSAIDs, morphine, amlodipine, diltiazem, verapamil, levodopa,
alprazolam, diazepam, trazodone.
Changes in elimination with age - Answers Decreased renal blood flow, decreased GFR, decreased
secretory function. Increased half-life of meds. Effects on cipro, macrobid, captopril, digoxin, enalapril,
lisinopril, furosemide, hydrochlorothiazide, glyburide, ranitidine, risperidone.
Pharmacodynamics - Answers Interaction between drug and body. Response at action site, side effects,
toxicity.
Pharmacodynamics age-related changes - Answers Decreased response to beta-adrenergic receptor
stimulators/blockers, decreased baroreceptor sensitivity, increased sensitivity to medications
(anticholinergics, benzodiazepines, narcotics, warfarin, diltiazem, verapamil).
Polypharmacy - Answers Concomitant administration of 5+ drugs contributes to an increase in adverse
effects & dangerous drug interactions, and decreases medication compliance.
ER visits - Answers Problems associated with anticoagulants (warfarin/Coumadin), antiplatelet drugs,
hypoglycemic agents, digoxin, insulin. Seen for GI bleeding, falls, delirium.
Toxicity factors - Answers Regular use (daily, prn), interactions (food, meds), long half life, disease
(kidney, liver), confusion.
Nursing role - Answers Know action & side effects, educate patient & family, check medications if any
changes occur.
OTC med safety - Answers Not safe just because they are available OTC, still need to report to provider.
May delay treatment by providing relief without addressing problem, use meds inappropriately,
interactions between meds. NSAIDs cause ulcers, interact with anticoagulants, ginseng; antihistamines
cause dehydration & sedation.
