BCGP study guide
BCGP · Work through your exam, one topic at a time.
The Board Certified Geriatric Pharmacist (BCGP) credential is a professional certification for licensed pharmacists who want to demonstrate specialized expertise in the care of older adults. It is typically pursued by pharmacists practicing in long-term care, ambulatory clinics, hospital geriatrics services, home-based care, and consultant pharmacy roles, as well as by those who teach or manage medication therapy in aging populations. The BCGP study guide has 11 sections and about 3,437 words.
01General Principles of Geriatric Care and Aging
Geriatric care rests on recognizing heterogeneity: chronological age predicts little compared with functional status, comorbidity burden, and physiologic reserve. Candidates must know the major aging theories only at a conceptual level (stochastic damage versus programmed senescence) and should focus energy on clinically testable constructs: homeostenosis (reduced capacity to maintain homeostasis under stress), frailty phenotypes (unintentional weight loss, exhaustion, weakness, slow gait, low activity), and the distinction between disability in activities of daily living (ADLs: bathing, dressing, toileting, transferring, feeding, continence) and instrumental activities (IADLs: finances, medications, transportation, shopping, cooking, telephone use).
344 words, about 2 min02Pharmacokinetics and Pharmacodynamics in Older Adults
Absorption changes are modest and rarely clinically decisive, though reduced gastric acidity, delayed gastric emptying, and first-pass variability matter for some agents. Distribution changes are more important: total body water falls, so hydrophilic drugs (gentamicin, lithium, alcohol) have smaller volumes of distribution and higher peak concentrations; body fat proportion rises, prolonging half-life of lipophilic drugs (diazepam, amiodarone, thiopental).
318 words, about 2 min03Cardiovascular Disorders
Treating hypertension in older adults reduces stroke and heart failure. Guidelines favor a target below 130/80 for community-dwelling ambulatory patients who tolerate it, with individualized goals in frailty or limited life expectancy.
323 words, about 2 min04CNS and Psychiatric Disorders
Distinguish delirium (acute onset, fluctuating course, inattention) from dementia (chronic, progressive) and depression (pseudodementia with low mood, anhedonia, preserved orientation). Delirium is a medical emergency: identify and treat precipitants - infection, medications (especially anticholinergics and sedatives), pain, urinary retention, constipation, dehydration, sensory deprivation.
311 words, about 2 min05Endocrine and Metabolic Disorders
Glycemic goals should be individualized: a reasonable A1C target for healthy older adults is below 7.0–7.5%, while frail patients with comorbidity or limited life expectancy may target below 8.0–8.5% to avoid hypoglycemia. Hypoglycemia is the dominant harm - it causes falls, fractures, arrhythmia, and cognitive decline.
305 words, about 2 min06Musculoskeletal and Pain Management
Osteoarthritis management centers on exercise, weight management, topical NSAIDs, and acetaminophen, with intra-articular glucocorticoids for flares. Oral NSAIDs should be used at the lowest dose for the shortest duration because of GI bleeding, renal injury, and cardiovascular risk; add a proton pump inhibitor or misoprostol when NSAIDs are unavoidable in high-risk patients, and avoid them in heart failure, CKD, and anticoagulation where possible.
325 words, about 2 min07Gastrointestinal, Renal, and Genitourinary Disorders
Constipation is common and often multifactorial: opioids, anticholinergics, calcium channel blockers, low fluid and fiber intake, immobility. Treat with osmotic agents (polyethylene glycol) and stimulant laxatives; avoid chronic stimulant overuse concerns only when truly indicated.
327 words, about 2 min08Respiratory and Infectious Diseases
Community-acquired pneumonia in older adults may present without fever or cough - confusion, falls, or functional decline may be the only signs. Assess severity with a validated tool such as CURB-65 (confusion, urea, respiratory rate, blood pressure, age 65 or older) to guide site of care.
304 words, about 2 min09Medication Safety, Polypharmacy, and Deprescribing
Polypharmacy (commonly five or more medications) is not inherently harmful, but inappropriate polypharmacy is. A prescribing cascade occurs when an adverse drug effect is treated as a new disease - for example, a calcium channel blocker causing edema treated with a diuretic, or an anticholinergic causing confusion treated with an antipsychotic.
298 words, about 1 min10Patient Assessment, Monitoring, and Care Transitions
A geriatric assessment spans function (ADLs/IADLs), cognition, mood, mobility and falls, nutrition and weight, continence, sensory function, pain, social support, and goals of care. Screening tools should be brief and validated.
294 words, about 1 min11Regulatory, Ethical, and Professional Practice Issues
Decision-making capacity is task-specific and assessed clinically: the patient must understand the relevant information, appreciate the consequences, reason about options, and communicate a choice. Capacity differs from competence, which is a legal determination.
288 words, about 1 min