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Dementia cholinesterase inhibitor adverse effect — GPhC CRA MCQ

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ModerateCNS TherapeuticsDementia cholinesterase inhibitor adverse effectGPhC CRA

An 82-year-old patient started donepezil 5 mg at night two weeks ago. Their carer reports dizziness and a pulse of 48 bpm. The patient also takes bisoprolol. What is the most appropriate action?

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Correct answer: D — Refer urgently for review because bradycardia may be medicine-related

Donepezil can cause bradycardia and syncope, and the risk may be increased with beta-blockers. A pulse of 48 bpm with dizziness requires prompt clinical review. The pharmacist should not independently stop beta-blocker therapy without clinical coordination. Sympathomimetic self-treatment would be unsafe.

Reference: BNF