OM is a 68 year old man who comes in today complaining that he cannot get to sleep or stay asleep and he feels miserable all the time. He just can’t seem to like anything anymore. His daughter is also here for this appointment to discuss his worsening dementia. She has been having a time watching him due to his lack of sleep. He has also been sneaking into her purse and stealing cigarettes when she dozes off. She thinks he might have to be put in a nursing home soon if this keeps up. He has a current medical history of diabetes, Parkinson’s, and dementia. He is currently on atorvastatin, lisinopril, aspirin, metformin, rasagiline, empagliflozin, and donepezil.
1. What non-pharm recommendations can you make?
2. What criteria would he have to meet to be treated for depression?
3. How would you treat OM? What alterations would you make to his medications?
4. If he was having LUTS, which BPH medication could also help with sleep?