A 77-year-old male presents to his GP complaining of forgetf…
A 77-year-old male presents to his GP complaining of forgetfulness. He explains that his poor memory has been troubling him for several months and appears to be worsening. The GP undertakes a cognitive assessment which indicates a degree of cognitive impairment. a. Explain which investigations the GP could undertake to identify any reversible causes of cognitive impairment, with a rationale for each (4 marks) The patient is referred to a psychiatrist who gives a diagnosis of dementia in Alzheimer’s disease and commences him on an acetylcholinesterase inhibitor. b. Recommend an appropriate acetylcholinesterase inhibitor for the patient, outlining how the dose should be titrated (2 marks) The patient is already on the following repeat medication from his GP: Amitriptyline 25mg at night (to aid sleep) Amlodipine 10mg once daily Aspirin 75mg once daily Atorvastatin 80mg at night Lansoprazole 15mg once daily Oxybutynin 2.5mg twice a day Ramipril 2.5mg once daily c. Explain what changes you would make to the repeat medication considering his diagnosis, providing a rationale (4 marks)