Geriatrics + Pall Care Flashcards
1
Q
First line medication for behavioural disturbance in dementia
A
Risperidone 0.25mf BD PRN
2nd line olanzapine 2,5mg OD
NEVER use first-gen antipsychotics if Lewy bodies, or Parkinsons
2
Q
Acute end of life pharmacological management (6)
A
- Cease orals if relevant
- Subcut morphine via syringe driver
- Subcut midazolam via syringe driver
- Subcut maxalon TDS
- Subcut Hyoscine butylbromide PRN
- Subcut Dexmethasone if relevant (brain, capsular)
3
Q
KFP: History for fitness to drive assessment (5)
A
- History of recent driving accidents
- Compliance with medication
- Any recent syncope
- Any hx of sleep disorder
- If DM - hypo awareness, or history of hypos
4
Q
KFP: Examination for fitness to drive (3)
A
- Visual assessment - acuity or field
- Assess co-ordination
- MMSE if not provided
5
Q
KFP: Other than hx and ex, what other tools can be used to assess fitness to drive (3)
A
- Referral to OT for driving assessment
- Collateral from relatives about driving ability
- Evaluation of cognition via neuropsychiatric assessment with geriatrician
6
Q
KFP: Assesed patient not fit to drive. Management steps? (4)
A
- Inform patient that they are not medical fit to drive
- Advise patient to notify the state authority re the outcome
- Offer assistance to look at alternative transport options (taxi subsidy if eligible)