Which endocrine medication increases risk of thrombotic events and possibly death in older adults with minimal effect on weight?

• A. Megestrol
• B. Growth hormone
• C. Desiccated thyroid
• D. Insulin sliding scale

Answer: (A)

Thromboembolism risk is the key safety concern for certain endocrine drugs in older adults. Megestrol acetate, used as an appetite stimulant in cachexia and similar conditions, has a well-documented association with venous thromboembolism and even death in older patients. This risk can be present even when weight change is not a primary or substantial effect, which is why it’s flagged as particularly unsafe in this population. The other meds listed don’t carry the same prominent thrombotic risk profile in older adults: growth hormone tends to cause edema and metabolic effects but not major thromboembolic risk; desiccated thyroid affects thyroid function without this thrombotic pattern; and sliding-scale insulin mainly poses hypoglycemia and related issues rather than thrombotic danger.