Geriatric Prescribing FNP Board Review
(Fitzgerald Info) Final Exam And 100%
Correct and Updated Answers 2025\2026
Verified.
Do PD (pharmacodynamics) or PK (pharmacokinetics) change with age? - Answer Only PK
T/F: General Pharm Rule in Prescribing for the Elder: Consider normative age related changes
and subsequent impact on drug choice and dose. - Answer True
Changes in Aging (Table) - Answer
Your patient is a 75 year-old man...who is in general good health with well-controlled HTN and
dyslipidemia.
He presents today with a chief complaint of difficulty initiating and maintaining sleep for about
the past
year. He drinks about 5 cups of coffee a day but states, "I really do not think this had anything to
it. I have done this for years."
What age-related changes might
be contributing to his problem? - Answer • Pharmacokinetic?
-Kidney
-Drug-metabolizing hepatic enzymes
• Pharmacodynamic?
• Others?
If albumin levels decrease with age, how does this impact protein bound drugs like coumadin
(99% bound)? - Answer More free drug, more drug effect
When compared with a healthy 40yo adult, CYP 450 isoenzyme levels can drop by up to 30% in
elders after age 70. - Answer True
T/F: CYP 450 1A2's activity is influenced by the presence or absence of estrogen in women. -
Answer True
, confusion, urinary retention, constipation,
visual disturbance, and hypotension. - Answer anticholinergic
If anticholinergic effect unavoidable,
choose the product in the class with the
least amount of this effect.
Medications with Significant
Anticholinergic Effects - Answer • 1st generation antihistamines
- Chlorpheniramine (Chlor-Trimeton®)
- Diphenhydramine (Benadryl®)
- Hydroxyzine (Atarax®)
- Cyproheptadine (Periactin®)
- Promethazine (Phenergan®)
• Doxepin (Sinequan®, Silenor®)
• Hydroxyzine, promethazine
• Highest risk
First Generation Antihistamines - Additional comments from Beers Criteria - Answer -
Clearance reduced with advanced age
- Tolerance develops when these products used as hypnotic
Commonly Used Meds in Elder with Anticholinergic Effects - Answer TCAs
1st generation antihistamines
overactive bladder antimuscarinics
Oxybutynin (Ditropan®) for overactive bladder
• immediate release vs sustained release: SR form=Better tolerance with similar
therapeutic efficacy
• used to tx sxs of overactive bladder, eg. urinary incontinence or overactive bladder
(Fitzgerald Info) Final Exam And 100%
Correct and Updated Answers 2025\2026
Verified.
Do PD (pharmacodynamics) or PK (pharmacokinetics) change with age? - Answer Only PK
T/F: General Pharm Rule in Prescribing for the Elder: Consider normative age related changes
and subsequent impact on drug choice and dose. - Answer True
Changes in Aging (Table) - Answer
Your patient is a 75 year-old man...who is in general good health with well-controlled HTN and
dyslipidemia.
He presents today with a chief complaint of difficulty initiating and maintaining sleep for about
the past
year. He drinks about 5 cups of coffee a day but states, "I really do not think this had anything to
it. I have done this for years."
What age-related changes might
be contributing to his problem? - Answer • Pharmacokinetic?
-Kidney
-Drug-metabolizing hepatic enzymes
• Pharmacodynamic?
• Others?
If albumin levels decrease with age, how does this impact protein bound drugs like coumadin
(99% bound)? - Answer More free drug, more drug effect
When compared with a healthy 40yo adult, CYP 450 isoenzyme levels can drop by up to 30% in
elders after age 70. - Answer True
T/F: CYP 450 1A2's activity is influenced by the presence or absence of estrogen in women. -
Answer True
, confusion, urinary retention, constipation,
visual disturbance, and hypotension. - Answer anticholinergic
If anticholinergic effect unavoidable,
choose the product in the class with the
least amount of this effect.
Medications with Significant
Anticholinergic Effects - Answer • 1st generation antihistamines
- Chlorpheniramine (Chlor-Trimeton®)
- Diphenhydramine (Benadryl®)
- Hydroxyzine (Atarax®)
- Cyproheptadine (Periactin®)
- Promethazine (Phenergan®)
• Doxepin (Sinequan®, Silenor®)
• Hydroxyzine, promethazine
• Highest risk
First Generation Antihistamines - Additional comments from Beers Criteria - Answer -
Clearance reduced with advanced age
- Tolerance develops when these products used as hypnotic
Commonly Used Meds in Elder with Anticholinergic Effects - Answer TCAs
1st generation antihistamines
overactive bladder antimuscarinics
Oxybutynin (Ditropan®) for overactive bladder
• immediate release vs sustained release: SR form=Better tolerance with similar
therapeutic efficacy
• used to tx sxs of overactive bladder, eg. urinary incontinence or overactive bladder
