Statins in the Elderly

Dina Baras Messenger, Optimized Prescribing with Seniors 5 Comments

Mildred is a generally healthy 85-year-old female. She has a history of osteoporosis and when she developed hypertension in her 60s she was placed on a statin. Issue Mildred has heard that statin use may lead to development of Alzheimer’s disease so asks if she needs to continue taking it. Background The 2016 Canadian Cardiovascular Society Guidelines for the Management …

Antidepressant use in later life depression

Dina Baras Messenger, Optimized Prescribing with Seniors 2 Comments

Suparna Madan BSc (CMMB), BSc (Psych), MD, FRCPC, Clinical Associate Professor, Section of Geriatric Psychiatry, Department of Psychiatry, University of Calgary Monica is an 84-year-old widowed woman with a recent onset of atrial fibrillation, treated with warfarin. She presents with a one-month history of irritable mood, headaches, insomnia, weight loss, memory complaints and psychomotor retardation. Issue What factors should be …

Hypertension in the elderly: Balance known benefits of treatment against the risks

College of Physicians and Surgeons of Alberta Optimized Prescribing with Seniors

John, an 85-year-old man, presents to your office complaining of light-headedness. He was recently admitted to hospital for congestive heart failure (CHF) and was started on furosemide, metoprolol and ramipril. He has a history of hypertension, dyslipidemia, benign prostatic hypertrophy and osteoarthritis. For these he was taking hydrochlorthiazide, discontinued during his hospital admission, atorvastatin, tamsulosin and acetaminophen. Issue Hypertension is ...

The DOACs: Look at individual patient characteristics

Collette D. Optimized Prescribing with Seniors

Smith is a 79 year old man who lives alone. He suffered a stroke two years ago so is taking Coumadin (warfarin) for non-valvular atrial fibrillation. His other significant medical history includes type 2 diabetes mellitus, hypertension, congestive heart failure and atrial fibrillation. His creatinine clearance (Crcl) is 52ml/min. He has been inconsistent with his warfarin use as it is …