Geriatric Psychiatry Flashcards
how do we approach meds with old ppl?
-start low, go slow
If we see depression in old people, what do we think of?
-pseudodementia
when do we see inappropriate behavior?
-frontotemporal dementia
what do we have to keep in mind with the tx of dementia in the elderly?
-avoid anticholinergic medications which can impair cognitive function, ESPECIALLY IN ELDERLY
Which drugs could we use for dementia?
- donepezil (AchE inhibitor)
- MEmantine (NMDA antagonist)
What drug do we want to avoid?
-benedryl and hydroxyzine
He said that Diphenhydramine will be on his test, wtf is that?
- it’s an antihistamine used to treat allergies!!! kinda like benedryl!!
- so we want to avoid the shit out of this drug in the elderly dementia pts
What are the black box warning things with antipsychotic medications?
- increased mortality
- Olanzapine
- Aripiprazole
- Risperidone
- quitiapine
Psychosis due to delirium?
- third most common cause of psychosis in elderly outpatients
- thought disturbance with themes that tend to be from the current environment and situations, with poverty of thinking and irrationality, and with hallucinations
Psychosis due to major depressive disorder
-second most common diagnosis in elderly outpatients, accounting for most psychosis in this population
psychosis due to alzheimer’s type dementia
-the most common diagnosis accounting for psychosis in elderly outpatients
What do we still need to have a high index of suspicion even in old ppl?
-substance abuse
What is the usually the answer when they are asking for treatment for these disorders?
- CBT
- cognitive behavioral therapy
What are the major depression criteria?
- Anhedonia or depressed mood for 2 weeks and 4 or more of the following
- feelings of wothlessness or guilt
- decreased ability to concentrate
- fatigue
- psychomotor agitation
- insomnia or hypersomnolence
- weight or appetite changes
- recurrent thoughts of suicide or death
How do differentiate between dementia and depression in the elderly population?
- mental status exam…. focus on the pt’s INSIGHT
- Depressed patients WILL often have INSIGHT, though little effort
- Dementia pts will have LITTLE/NO INSIGHT