A patient with Alzheimer’s disease is taking donepezil to treat cognitive symptoms. The patient and report noting increase social withdrawal and sleep impairment. What is an initial step to manage a symptoms?
Added by Juan W.
Step 1
Step 1: Assess the patient's current medication regimen and confirm adherence to donepezil, ensuring that the dosage is appropriate and that the patient is taking it as prescribed. Show more…
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RS is a 75-year-old man who has been recently discharged from the hospital following treatment for a fall at home. He lives with his 45-year-old daughter and her family and relies on them to assist with his medical needs. According to his daughter, his main issues currently involve problems with his short-term memory and insomnia. Nevertheless, she believes that since commencing donepezil, at a dose of 10 mg, one tablet at night, RS's cognitive function has improved. RS is also taking the H1 antihistamine promethazine 10 mg, one tablet at night, 'to help him to improve his memory and sleep', according to his daughter. He has also been taking the benzodiazepine diazepam 10 mg at night for the past five years to assist him with his sleep. Questions 1. Explain the mechanism of action of donepezil in improving RS's cognitive function. (one point; this involves relating what the medication does to what is happening in the brain of those with Alzheimer's disease) 2. What potential problem is there with RS taking promethazine as a part of his medication regimen? What action should be taken in relation to this medicine? (one point) 3. After seeing the doctor, it is suggested that RS would benefit from ceasing the diazepam treatment. Why is this best for RS? Explain how diazepam should be ceased. (one point)
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