AD- Drugs That Worsen Cognitive Decline and Management

Question 1

Cognitive impairment signs

Answer 1

Mydriasis, dry skin, fever, depression/agitation, flushed skin

Question 2

Drugs that can worsen cognitive decline

Answer 2

Cimetidine, prednisolone, theophylline, digoxin, nifedipine, furosemide, ranitidine, isosorbide dinirate, warfarin, triamterene/HCTZ, captopril, diphenhydramine, oxybutynin, antiemetics/antivertigo, PD meds, TCas, typical APS (chlorpromazine, thioridazine), atypical APS (clozapine)

Question 3

Cumulative anticholinergic use is associated with an increased risk of…

Answer 3

dementia

Question 4

Pharmacologic intervention for behaviors in AD

Answer 4

ADs, anxiolytics, APS, AEDs

Question 5

Pharmacologic intervention for sleep changes

Answer 5

TCAs, benzos, sedative/hypnotics, APS

Question 6

Nonpharm interventions

Answer 6

Provide structure and routine, follow regular and predictable routines, encourage pleasant activities that the patient enjoyed in the past, keep things simple, break down complex tasks, know when to walk away and come back at a later time if the patient is agitated

Question 7

GDR guidelines

Answer 7

Attempt a GDR in two separate quarters with at least one month in between attempts when the patient is at the facility/nursing home