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Chronic benzodiazepine use in elderly patients increases fall, delirium, and dependence risk. The best intervention is gradual tapering and non-drug interventions (sleep hygiene, CBT). Barbiturates (A) are more dangerous. Unlimited refills (C) perpetuate risk. Doing nothing (D) fails to meet geriatric best practices.

Deprescribing initiatives require structured protocols where pharmacists review indication, duration, and appropriateness. Long-term use should be limited to evidence-based indications (GERD, Barrett’s, NSAID prophylaxis in high-risk patients). Formulary removal (A) is unsafe. Arbitrary duration limits (C) ignore individual needs. Automatic switching (D) is inappropriate. Pharmacist-led review ensures safe and effective deprescribing.

Potassium chloride must always be diluted and infused slowly. Rapid IV push causes fatal cardiac arrhythmias. Magnesium and calcium require slow infusion but may be given IV in some cases. Sodium bicarbonate can be given IV push in emergencies. Strict infusion protocols prevent KCl errors.

With INR >8 but no active bleeding, guidelines recommend holding warfarin and giving a low dose of oral vitamin K (2.5–5 mg) to reduce INR safely. Continuing therapy (B) is dangerous. IV vitamin K and FFP (C) are reserved for life-threatening bleeding. Permanent discontinuation (D) is not indicated. This management balances bleeding risk with resumption of anticoagulation once INR stabilizes.

Amiodarone contains iodine and alters thyroid hormone metabolism. It can cause both hypothyroidism (inhibition of T4 → T3 conversion) and hyperthyroidism (iodine-induced thyrotoxicosis). Diltiazem, flecainide, and sotalol do not affect thyroid function to this degree. Baseline and periodic TSH monitoring is essential.