Dipyridamole is inappropriate for routine use in older adults, but the IV formulation is acceptable for which purpose?

• A. Oral vaccination
• B. Systemic anticoagulation
• C. Oral hypoglycemic therapy
• D. Cardiac stress testing (IV dipyridamole)

Answer: (D)

The key idea is that Beers Criteria allow an exceptional diagnostic use for certain drugs when benefits outweigh risks in older adults. Dipyridamole, given intravenously, is used briefly to perform pharmacologic cardiac stress testing. It causes a transient increase in coronary vasodilation, which helps reveal perfusion defects on imaging. This short, controlled, test-specific use is why the IV form is considered acceptable, even though routine oral dipyridamole is avoided due to adverse effects like hypotension and dizziness.

The other listed uses don’t fit the context: vaccination, systemic anticoagulation, and oral hypoglycemic therapy are not indications for dipyridamole in older adults.