TD in Older Adults : Pre-test

1.

Which of the following factors do NOT contribute to the increased risk of TD in older patients compared to younger patients?

A. Decreased number of dopaminergic neurons in motor circuitry
B. Diminished immune functioning
C. More likely to have been treated with first-generation (typical) antipsychotics
D. Statistically longer duration of mental illness

2.

You are treating a 68-yr-old patient with fluoxetine and olanzapine for depression. She wears dentures and notes she sometimes has trouble keeping them in her mouth. Over a period of 1 mo, when AIMS is performed without wearing her dentures, she shows movements involving lips, tongue, and jaw. No involuntary movements are seen in other parts of her body. Would you diagnose this patient with TD and offer treatment?

A. Yes
B. No, because TD diagnosis requires moderate or severe movements
C. No, because TD diagnosis requires movements in both facial and nonfacial areas
D. No, because she was not aware of the movements

3.

A 70-yr-old patient with schizophrenia, currently treated with olanzapine and fluoxetine, would like to initiate a VMAT2 inhibitor for symptoms of TD. He also has mild renal impairment. What are his FDA-approved treatment options, considering label recommendations?

A. Either deutetrabenazine or valbenazine with no adjustments needed to starting dose
B. Either deutetrabenazine or valbenazine, at lower starting dose due to 2D6 inhibition from fluoxetine
C. Either deutetrabenazine or valbenazine, at lower starting dose due to renal impairment
D. Valbenazine at lower starting dose due to 2D6 inhibition from fluoxetine (deutetrabenazine is contraindicated by renal impairment)

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Critical Screening and Timely Diagnosis of Tardive Dyskinesia in Older Adults: Evidence-Based Strategies for Clinical Practice

Jeremy A. Schreiber, MSN, APRN, PMHNP-BC

Pretest

Please answer the questions below.

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