Prescribing

Question 1

What criteria should you use to start and discontinue medications in the elderly?

Answer 1

1. START criteria

2. STOPP criteria

Question 2

When should NSAIDs be used in the elderly and what should they be given with?

Answer 2

1. Only in very specific cases

2. PPI

Question 3

What should be tried before NSAIDs for pain relief in the elderly?

Answer 3

1. Weight reduction, warmth, exercise, walking stick use

2. Paracetamol, then add opioid analgesic

Question 4

What should diuretics not be used for in the elderly and how could it be managed instead?

Answer 4

1. Long-term for simple gravitational oedema.

2. Increased movement, raising the legs, support stockings.

Question 5

What should you avoid in the use of hypnotics in the elderly and what are the side effects to be aware of?

Answer 5

1. Long courses (risk of dependence)

2. Drowsiness, unsteady gait, slurred speech, confusion.