BEHAVIORAL Flashcards
In the elderly, what are some of the common sxs of depression?
Fatigue, disturbed sleep, and diminished appetite
If we are concerned about depression in the elderly, what labs do we get?
TSH B12, CrCl, electrolytes, Ca, UA, and CBC
How do we correctly prescribe SSRI’s?
Adequate titrate of 4-6 weeks
F/U in 2 weeks to check s/e’s and see if dose needs to be increased
For the elderly, what’s our 1st line SSRI’s?
Citalopram, escitalopram, and sertraline
What are 2nd line SSRI’s for the elderly?
Fluoxetine or paroxetine or switch class based on symptoms
What are the common S/E’s of SSRI’s?
Anxiety, agitation, N/D, sexual effects
With aging, what can occur with out sleep?
Decreased sleep efficiency, total sleep time, more arousal during the night, more napping, decreases in deeper stages of sleep
How would you screen an elderly person for sleep problems?
satisfied with your sleep? Sleep/fatigue interfere with daytime activities?
What are the 3 diagnostic criteria of a sleep disorder?
Difficulty falling asleep/staying asleep
Waking too early
Non-restorative sleep
What is a common cause of sleep problems?
depression!
What are 2 common types of sleep disorders?
Central sleep apnea & Obstructive
What is occurring with central sleep apnea?
cessation of breathing without associated respiratory effort
*Associated with opioid/stroke/HF
What is the key descriptive term of central sleep apnea?
Cheye-Strokes
What are some other causes of sleep problems?
Restless leg syndrome, periodic limb movements, REM sleep behavior, and dementia
Where do you start with treating sleep problems?
Melatonin and Sleep Hygiene
