NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which of the following should be avoided in elderly due to the risk of adverse effects?

  1. Second generation oral antihistamines

  2. First generation antihistamines

  3. Intranasal steroids

  4. Decongestants

The correct answer is: First generation antihistamines

First generation antihistamines should be avoided in the elderly due to the risk of adverse effects such as sedation, cognitive impairment, anticholinergic effects, and potential interactions with other medications. These medications can increase the risk of falls and confusion in elderly patients. On the other hand, second generation oral antihistamines are preferred in the elderly population as they have a lower incidence of adverse effects such as sedation and anticholinergic effects. Intranasal steroids and decongestants are generally considered safe for use in the elderly population compared to first generation antihistamines.