Pharmacological treatment of urinary incontinence in the elderly

Dina Baras CPSA, Messenger, Optimized Prescribing with Seniors Leave a Comment

Phyllis, a 78-year-old woman with mild COPD comes to your office for a routine disease-monitoring visit. During the consultation, she tells you that she has been experiencing severe urinary urgency for many months and has had several accidents on the way to the washroom over the last few weeks.  She hadn’t mentioned this before as she was embarrassed and thought …

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 ...