The flu vaccine: Why its efficacy outweighs its risks

College of Physicians and Surgeons of Alberta Messenger, Optimized Prescribing with Seniors 1 Comment

Susan is a health care aide. Her grandfather, who is 86, has been fairly healthy and lives independently. He receives some support for instrumental ADL from his daughter and Susan. He has type 2 diabetes, hypertension and chronic obstructive pulmonary disease (COPD). For this he takes metformin, gliclazide, losartan and tiotropium. He has salbutamol that he uses only occasionally. Susan …

Pharmacological factors and falls in the elderly

College of Physicians and Surgeons of Alberta Optimized Prescribing with Seniors Leave a Comment

George is a 93-year-old male who lives with his son and daughter-in-law. Over the last six months, he has become frailer but continues to be reasonably independent. He is treated for hypertension, dyslipidemia, BPH, and has arthritis in his knees. He complained of feeling depressed when he moved in with his son after the death of his wife five years …

Medication management: Recognizing anticholinergic effects

College of Physicians and Surgeons of Alberta Messenger, Optimized Prescribing with Seniors Leave a Comment

Myrtle is an 87-year-old female with hypertension, urinary urgency and a mild dementia syndrome. She lives with her daughter and manages with her support. She is taking hydrochlorothiazide, amlodipine, ASA, tolterodine LA, and mirtazapine for sleep. Myrtle recently slipped on the stairs and twisted her back. Because of the pain, she started taking acetaminophen/methocarbamol. Her daughter brings her in because …

Tackling GERD (common and atypical symptoms) in older patients

College of Physicians and Surgeons of Alberta Messenger, Optimized Prescribing with Seniors Leave a Comment

George, a 78 year old male, comes in to your office for an initial visit as his previous physician has retired. His chronic medical issues are managed and stable, but he has been having increasing heartburn. He takes an antacid as needed but is not finding this to be sufficient. Issue: What does the evidence say about investigation and management …