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Medication adverse effect — RCPSC IM MCQ

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HardGeneral IM, Ethics, CanMEDSMedication adverse effectRCPSC IM

A 77-year-old with recurrent falls, confusion, dry mouth, constipation, urinary retention and blurred vision takes amitriptyline, oxybutynin, zopiclone and diphenhydramine. What is the most appropriate intervention?

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Correct answer: A — Deprescribe anticholinergic and sedative contributors through structured review

The best answer is “Deprescribe anticholinergic and sedative contributors through structured review”. The combined anticholinergic and sedative burden explains the cognitive, autonomic and fall symptoms. A planned deprescribing review addresses indications, withdrawal risk and safer alternatives; adding medication or investigating repeatedly without correcting the exposure perpetuates harm.

Reference: Canadian Family Physician, evidence-based deprescribing guideline. https://www.cfp.ca/content/64/5/339