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Flashcards in Geriatric Psych - Hill Deck (18):
1

Dementia - definition

Example symptoms?

Decreased intellectual function without affecting consciousness

Memory loss, apraxia, aphasia, agnosia, loss of abstract thought, personality changes, impaired judgment

2

Irreversible causes of dementia

Alzheimer's, Lewy body, Huntington, Pick's (frontotemporal), vascular disease (infarct, etc.)

3

Reversible causes of dementia (pseudodementia)

**Hypothyroidism, **depression, **vitamin B12 deficiency, normal pressure hydrocephalus, neurosyphilis, hematoma, drug-induced

4

Dementia, urinary incontinence, ataxia

Normal pressure hydrocephalus

5

Elderly patient, weight loss, anxiety, irritability, sadness, social withdrawal, memory loss, dementia

Treatment? Best drug

Pseudodementia -- depression-induced


Treat the depression -- NORTRIPTYLINE***

6

Treating dementia -- best approach?

Drug combo?

Drugs PLUS therapy (CBT)

Donepezil + memantine

7

A patient comes in with memory symptoms. FIRST thing to do?

Neuropsych testing -- establish a baseline (esp. early on)

8

Drugs to AVOID in elderly w/ dementia

Why?

Anticholinergic -- Benadryl (diphenhydramine), Hydroxyzine

Will cause impaired cognition -- delirium, bad dementia

9

Treating psychosis in elderly dementia patient


Importance?

Atypical antipsychotic -- olanzapine, aripiprazole, risperidone, quetiapine

BLACK BOX WARNING -- SUDDEN DEATH

10

What can cause psychosis in the elderly?

Delirium -- acute medical condition or drug issue
Major depressive disorder w/ psychotic features
Alzheimer's type dementia -- paranoid delusions

11

Treating delirium tremens in elderly

Benzos, Naltrexone

12

How to differentiate btwn dementia and depression in the elderly?

INSIGHT -- will have insight in depression

13

An elderly patient with depression takes an SSRI. Caution?

Serotonin syndrome

14

An elderly patient with depression takes Mirtazapine. Caution?

Increased appetite

15

An elderly patient has depression as well as a chronic pain condition. Best drugs?

SNRIs (Venlafaxine, Duloxetine)

16

An elderly patient has depression and insomnia. Best drug?

Trazodone

17

An elderly patient has depression and a history of seizures. What not to give?

Bupropion

18

An elderly patient has depression. What is Dr. Hill's favorite drug to use?

Nortriptyline (TCA)