Which medication is matched correctly to the condition given of an older adult patient according to current medical knowledge?
a. Methylphenidate (Ritalin) for depression at bedtime
b. Buspirone (BuSpar) for chronic anxiety states
c. Amitriptyline (Elavil) for depression in the morning
d. Haloperidol (Haldol) long-term for psychotic behavior
B
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A Incorrect. Stimulants such as methyphenidate (Ritalin) should be given in very low doses in cases of chronic depression; to prevent insomnia, extended-release forms should be administered early in the morning and shorter-acting forms at the latest in the early afternoon.
B Correct. Buspirone (BuSpar) is safer for older adults than benzodiazepines for anxiety. Because it can take up to 5 to 7 days for the therapeutic benefit to be felt, it should be used only for chronic anxiety.
C Incorrect. Tricyclic antidepressants such as amitryptaline (Elavil) are contrain-dicated for use with older adults because of the risk for anticholinergic and sed-ative effects. Tricyclic antidepressants have been replaced with selective seroto-nin reuptake inhibitors (SSRIs), which are more effective at lower doses with fewer side effects.
D Incorrect. Antipsychotic agents such as haloperidol (Haldol) can cause extrapy-ramidal effects, especially in older adults. For long-term administration, they should be used only after a thorough psychiatric evaluation.
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