General Principles of Geriatric Drug Therapy

Ms. Gutierrez is a 74-year-old female with a history of atrial fibrillation, type 2 diabetes, and hypertension. She recently visited her primary care provider (PCP) due to trouble sleeping at night. Her PCP prescribed zolpidem 5 mg at bedtime as needed for sleep without inquiring about patient preference for treatment. Despite taking zolpidem nightly for several weeks, Ms. Gutierrez continued to have trouble sleeping, so she purchased an over the counter medication to help. While her sleep improved, she noticed she had some nighttime incontinence and fell twice in the last week getting out of bed. She returned to her PCP who prescribed her tolterodine for incontinence symptoms and told her to rise slowly from her bed each morning.