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Questions and Answers
What is the primary concern associated with the chronic use of antipsychotics in older adults?
What is the primary concern associated with the chronic use of antipsychotics in older adults?
What is a recommended approach when managing pain in older adults to minimize opioid use?
What is a recommended approach when managing pain in older adults to minimize opioid use?
Why should anticholinergics be avoided in older adults?
Why should anticholinergics be avoided in older adults?
Which of the following statements about benzodiazepines is correct?
Which of the following statements about benzodiazepines is correct?
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What aspect of opioid administration in older adults is highlighted by emerging data?
What aspect of opioid administration in older adults is highlighted by emerging data?
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What is the recommendation regarding aspirin for the primary prevention of cardiovascular disease in older adults?
What is the recommendation regarding aspirin for the primary prevention of cardiovascular disease in older adults?
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What change was made regarding rivaroxaban in the 2023 AGS Beers Criteria®?
What change was made regarding rivaroxaban in the 2023 AGS Beers Criteria®?
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Why was rivaroxaban's recommendation changed?
Why was rivaroxaban's recommendation changed?
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What does Table 7 list in the 2023 AGS Beers Criteria®?
What does Table 7 list in the 2023 AGS Beers Criteria®?
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Which of the following anticoagulants poses a higher risk of bleeding compared to apixaban?
Which of the following anticoagulants poses a higher risk of bleeding compared to apixaban?
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What has been clarified in the special box summarizing the criteria for anticoagulants?
What has been clarified in the special box summarizing the criteria for anticoagulants?
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What is the overall stance of the AGS Executive Committee on aspirin use in older adults?
What is the overall stance of the AGS Executive Committee on aspirin use in older adults?
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What is stated regarding older adults already on aspirin for primary prevention?
What is stated regarding older adults already on aspirin for primary prevention?
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Under what circumstances should antipsychotics be used for behavioral problems in older adults?
Under what circumstances should antipsychotics be used for behavioral problems in older adults?
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What is the recommended approach regarding the dosage of corticosteroids for older adults?
What is the recommended approach regarding the dosage of corticosteroids for older adults?
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What should be considered when using antipsychotics in older adults?
What should be considered when using antipsychotics in older adults?
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Which of the following medications are categorized under antipsychotics according to the AGS 2023 Beers Criteria?
Which of the following medications are categorized under antipsychotics according to the AGS 2023 Beers Criteria?
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What is a key factor in the administration of benzodiazepines to older adults?
What is a key factor in the administration of benzodiazepines to older adults?
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When should periodic deprescribing attempts be conducted for patients on antipsychotics?
When should periodic deprescribing attempts be conducted for patients on antipsychotics?
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Which of the following medications could potentially lead to delirium and should be monitored carefully?
Which of the following medications could potentially lead to delirium and should be monitored carefully?
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What should be prioritized when treating older adults with pharmacologic options?
What should be prioritized when treating older adults with pharmacologic options?
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What is the recommended practice when prescribing certain medications for schizophrenia and bipolar disorder?
What is the recommended practice when prescribing certain medications for schizophrenia and bipolar disorder?
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Which forms of corticosteroids are excluded from the recommendation?
Which forms of corticosteroids are excluded from the recommendation?
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What is the significance of the ratings of quality of evidence and strength of recommendation?
What is the significance of the ratings of quality of evidence and strength of recommendation?
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What should be considered when prescribing oral and parenteral corticosteroids?
What should be considered when prescribing oral and parenteral corticosteroids?
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Under the Beers Criteria, how are drugs listed within specific classes treated?
Under the Beers Criteria, how are drugs listed within specific classes treated?
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What is noted about the selective peripheral alpha-1 blockers in the Beers Criteria?
What is noted about the selective peripheral alpha-1 blockers in the Beers Criteria?
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What should be a priority when treating conditions like exacerbation of COPD with corticosteroids?
What should be a priority when treating conditions like exacerbation of COPD with corticosteroids?
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What implication does the Beers Criteria hold for drugs used in older adults?
What implication does the Beers Criteria hold for drugs used in older adults?
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Which drug carries a significant increased risk of gastrointestinal bleeding compared to warfarin when used for long-term treatment?
Which drug carries a significant increased risk of gastrointestinal bleeding compared to warfarin when used for long-term treatment?
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What is the primary concern when using Dabigatran for long-term treatment in older adults?
What is the primary concern when using Dabigatran for long-term treatment in older adults?
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Prasugrel may be used with caution in which demographic, particularly due to the risk of major bleeding?
Prasugrel may be used with caution in which demographic, particularly due to the risk of major bleeding?
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What should be closely monitored when starting or changing dosages of selected antidepressants in older adults?
What should be closely monitored when starting or changing dosages of selected antidepressants in older adults?
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When considering the use of DOACs for long-term treatment, which drug is advised to be chosen with caution over others like apixaban?
When considering the use of DOACs for long-term treatment, which drug is advised to be chosen with caution over others like apixaban?
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What may offset the risk of major bleeding when using Ticagrelor in older adults?
What may offset the risk of major bleeding when using Ticagrelor in older adults?
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Among the listed antidepressants, which class is known to potentially exacerbate SIADH or cause hyponatremia?
Among the listed antidepressants, which class is known to potentially exacerbate SIADH or cause hyponatremia?
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Which rationale supports the cautious selection of Dabigatran over other direct oral anticoagulants (DOACs) in older adults?
Which rationale supports the cautious selection of Dabigatran over other direct oral anticoagulants (DOACs) in older adults?
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Study Notes
2023 AGS Beers Criteria® Updates
- The American Geriatrics Society (AGS) has updated the Beers Criteria® for potentially inappropriate medications in older adults.
- The 2023 update focusses on drug classes and recommendations for use in older adults.
- Changes in anti-coagulant recommendations: The criteria for anti-coagulants like warfarin, rivaroxaban, and dabigatran have been revised.
- Rivaroxaban: The recommendation for rivaroxaban for long-term treatment of non-valvular atrial fibrillation and venous thromboembolism (VTE) has changed from "use with caution" to "avoid".
- Dabigatran: The recommendation for dabigatran for similar conditions is now considered to be "use with caution" when compared to other DOACs.
- Antipsychotic use for dementia: The criteria now recommend that antipsychotics should be avoided for behavioral problems of dementia or delirium unless non-pharmacological options have failed or are not possible.
- The updated criteria also include information about various drug classes and their impact on older adults, particularly highlighting risks and recommended approaches to use.
- Anticholinergics: These are generally avoided due to their CNS effects, and specific criteria are offered for individual drugs in this class.
- Opioids: The criteria highlight the potential association between opioid administration and delirium and advocate for a balanced approach to pain management.
- Benzodiazepines: The criteria recommend using the lowest effective dose and the shortest duration for benzodiazepine use in older adults.
- Corticosteroids: Similar recommendations for lowest effective doses and shortest duration are made for corticosteroids.
- Antidepressants: The criteria highlight the potential for selected antidepressants like mirtazapine, SNRIs, and SSRIs to exacerbate or cause SIADH or hyponatremia. Sodium levels should be monitored closely when starting or adjusting dosages.
- Prasugrel and Ticagrelor: These drugs are associated with an increased risk of major bleeding in older adults, especially those 75 years and older. The criteria recommend caution with their use in older adults, and consideration for a lower dose of prasugrel (5 mg) for those 75 years and older.
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Description
Explore the latest updates to the AGS Beers Criteria for potentially inappropriate medications in older adults. This quiz focuses on significant changes, including anticoagulant recommendations and guidance on antipsychotic use for dementia. Test your knowledge on these essential updates that impact prescribing practices for older patients.
