Beers Criteria
Beers Criteria
1. Which organization originally developed the Beers Criteria?
A. WHO
B. American Geriatrics Society
C. FDA
D. CDC
Answer: B. American Geriatrics Society
Explanation: The AGS maintains and updates the Beers Criteria, which lists potentially inappropriate medications in older adults.
2. Beers Criteria is most commonly used for which patient group?
A. Pediatric population
B. Pregnant women
C. Geriatric population
D. Cancer patients
Answer: C. Geriatric population
Explanation: The criteria are tailored to reduce adverse drug events in patients aged 65 and older.
3. Which of the following drugs is considered inappropriate in elderly due to risk of falls?
A. Metformin
B. Warfarin
C. Amitriptyline
D. Omeprazole
Answer: C. Amitriptyline
Explanation: Amitriptyline, a tricyclic antidepressant, increases fall risk due to its anticholinergic and sedative properties.
4. According to Beers Criteria, which class of medications should be avoided in elderly due to anticholinergic burden?
A. SSRIs
B. Antihistamines (1st gen)
C. Beta-blockers
D. Calcium channel blockers
Answer: B. Antihistamines (1st gen)
Explanation: First-generation antihistamines like diphenhydramine have strong anticholinergic effects.
5. Why are benzodiazepines listed in the Beers Criteria for older adults?
A. Risk of addiction
B. Risk of falls and cognitive impairment
C. Ineffectiveness
D. Expense
Answer: B. Risk of falls and cognitive impairment
Explanation: Benzodiazepines increase the risk of confusion, falls, and delirium in older adults.
6. Which medication should be avoided in older adults with chronic constipation?
A. Docusate
B. Polyethylene glycol
C. Diphenoxylate
D. Psyllium
Answer: C. Diphenoxylate
Explanation: Diphenoxylate is an antidiarrheal with anticholinergic activity, worsening constipation.
7. What is the main goal of the Beers Criteria?
A. Promote drug compliance
B. Improve pediatric prescribing
C. Guide safe medication use in older adults
D. Decrease healthcare costs
Answer: C. Guide safe medication use in older adults
Explanation: The criteria aim to minimize adverse effects and improve medication safety in the elderly.
8. Which PPI is flagged for caution in long-term use in elderly due to fracture and C. difficile risks?
A. Lansoprazole
B. Esomeprazole
C. Pantoprazole
D. All of the above
Answer: D. All of the above
Explanation: Long-term use of PPIs is associated with osteoporosis-related fractures and infections.
9. Which of the following is a reason to potentially avoid NSAIDs in older adults?
A. Renal dysfunction
B. Risk of bleeding
C. Hypertension
D. All of the above
Answer: D. All of the above
Explanation: NSAIDs increase the risk of kidney injury, GI bleeding, and worsen hypertension.
10. What is the update frequency of the AGS Beers Criteria?
A. Every year
B. Every 2 years
C. Every 3 years
D. Every 10 years
Answer: C. Every 3 years
Explanation: The AGS updates the criteria roughly every 3 years to reflect emerging evidence.
The Beers Criteria (developed by the American Geriatrics Society) is a guideline for healthcare professionals to help improve the safety of prescribing medications for older adults (65+). Here are 10 key points about the Beers Criteria:
Beers Criteria
Beers Criteria – 10 Key Points
- Target Population: Applies primarily to adults 65 years and older, not necessarily to palliative or hospice care patients.
- Purpose: Aims to reduce adverse drug events (ADEs) and improve medication selection by identifying potentially inappropriate medications (PIMs).
- Drug Categories: Includes medications that should generally be avoided, used with caution, or avoided in specific conditions.
- Examples of PIMs:
- Anticholinergics (e.g., diphenhydramine) – due to risk of confusion, constipation, and falls.
- Benzodiazepines – due to increased fall and cognitive impairment risk.
- Non-benzodiazepine hypnotics (e.g., zolpidem) – same concerns as benzos.
- Renal Function Considerations: Highlights drugs needing dose adjustment or avoidance in older adults with reduced kidney function (e.g., nitrofurantoin, digoxin).
- Drug-Disease Interactions: Lists medications to avoid in specific chronic conditions (e.g., NSAIDs in chronic kidney disease, antipsychotics in dementia).
- Drug-Drug Interactions: Identifies clinically significant interactions, such as combinations increasing the risk of bleeding (e.g., warfarin + NSAIDs).
- Use With Caution: Some drugs are not entirely contraindicated but should be used carefully (e.g., diuretics due to risk of hyponatremia).
- Regular Updates: The criteria are periodically updated (most recent version: 2023) based on emerging evidence and expert consensus.
- Not a “Do Not Use” List: The Beers Criteria is a guideline, not an absolute rule. Clinical judgment should be used, considering individual patient needs.
