Pharmacological Interventions Flashcards
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Read the first 7 Pharmacological Interventions flashcards as text
Which antipsychotic carries an FDA black box warning specifically for increased mortality risk when used in elderly patients with dementia-related psychosis?
Answer: All antipsychotics, both typical and atypical
The FDA black box warning applies to all antipsychotic medications—both typical and atypical—regarding increased mortality in elderly patients with dementia-related psychosis.
A person with Alzheimer's develops severe agitation during late-afternoon hours daily. Before considering pharmacological treatment, the standard guideline-recommended first step is:
Answer: Identify and address potential non-pharmacological triggers
Guidelines consistently recommend non-pharmacological interventions as first-line treatment for behavioral symptoms before considering medications.
Tacrine (Cognex) was the first FDA-approved cholinesterase inhibitor for Alzheimer's but is no longer used primarily because of:
Answer: Serious hepatotoxicity requiring frequent liver monitoring
Tacrine was withdrawn from clinical use due to significant hepatotoxicity, with patients requiring frequent liver function monitoring.
When discontinuing a cholinesterase inhibitor after long-term use, the recommended approach is:
Answer: Gradual tapering over several weeks
Abrupt discontinuation of cholinesterase inhibitors can cause rapid cognitive or behavioral decline; gradual tapering is recommended to minimize this risk.
Which medication class should generally be AVOIDED in Alzheimer's patients because anticholinergic effects can worsen cognitive function?
Answer: First-generation antihistamines like diphenhydramine
Anticholinergic medications like diphenhydramine block the acetylcholine system, directly counteracting cholinesterase inhibitor therapy and worsening cognition.
Suvorexant (Belsomra), an orexin receptor antagonist, is FDA-approved for treating which specific symptom in Alzheimer's disease?
Answer: Insomnia
Suvorexant received FDA approval specifically for treating insomnia in patients with Alzheimer's disease in 2022.
The 'start low, go slow' prescribing principle in Alzheimer's pharmacotherapy primarily exists because older adults with dementia often have:
Answer: Altered pharmacokinetics and increased sensitivity to CNS drugs
Aging and dementia alter drug absorption, distribution, metabolism, and excretion, while also increasing CNS sensitivity, necessitating conservative dosing.