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Centre for Policy on Ageing | |
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Cardiac monitoring for cholinesterase inhibitors
— a survey | | Author(s) | Dirk Maliepaard, Tom MacEwan |
| Journal title | International Psychogeriatrics, vol 21, no 3, June 2009 |
| Pages | pp 457-462 |
| Keywords | Dementia ; Drugs ; Cardiovascular systems ; Screening ; Aberdeen. |
| Annotation | There is no consensus on the monitoring for rare but potentially serious cardiac adverse events associated with cholinesterase inhibitor drugs in the treatment of dementia. Different protocols have been proposed, with and without ECG examination. The researchers surveyed an urban old age psychiatry service in Aberdeen to investigate the variables that may influence the implementation of such protocols. Case notes of 45 consecutive patients assessed for dementia were scrutinised, to establish how many underwent an ECG or other cardiac examination prior to drug treatments. Data were collected on demographics, medical conditions and drug treatments. Patient files were searched for indications of investigations and any outcomes. Half of all patients treated with a cholinesterase inhibitor (11/22) had an ECG before treatment. In 5 cases, no pulse or cardiac symptoms were recorded in the absence of an ECG. Medical history, findings on examination, seniority of the clinician, and patient cooperation all may have influenced whether patients had an ECG. In 3 cases, treatment was not prescribed due to concerns over cardiac effects, and with 5 ECGs, new diagnoses were made. A protocol based on pulse monitoring would only have indicated ECGs in 2 out of 22 cases. Several factors may influence decisions on cardiac monitoring. Fewer ECGs could be done if only pulse and cardiac symptoms were monitored before cholinesterase inhibitor prescription, but new cardiac diagnoses might then be missed. Protocols can be devised to incorporate both cardiac investigation and cholinesterase inhibitor monitoring. (KJ/RH). |
| Accession Number | CPA-090616216 A |
| Classmark | EA: LLD: BKK: 3V: 9ND |
Data © Centre for Policy on Ageing |
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| ...from the Ageinfo database published by Centre for Policy on Ageing. |
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