Case scenario

John is an 82-year-old man with a history of hypertension and Alzheimer’s disease. He has no allergies nor other comorbidities. A baker for his entire working life, John moved into a residential aged care facility (RACF) two months ago due to progression of his Alzheimer’s disease, which now prevents him from undertaking most activities of daily living.

His only medications are amlodipine 5 mg in the morning and donepezil 10 mg at night.

Care staff at the RACF generally find it quite straightforward to care for John during the day. However, he wakes up very early most mornings (around 2 am), and either walks aimlessly around the facility or tries to enter the kitchen. John becomes very agitated whenever he is redirected back to his bed, and on two of these occasions during the previous week, he slapped a carer who was trying to re-settle him.

A comprehensive medical assessment excluded the potential for John’s aggression to be due to pain, constipation or infection. The clinical nurse manager intends to request that John’s GP consider commencing him on an antipsychotic medication.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Describe how and why antipsychotics are used in the aged care setting
  • Identify when the use of antipsychotics is inappropriate
  • Discuss t

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