Professional and Linguistic Assessments Board (PLAB) Practice Exam

What should be closely monitored when prescribing antipsychotics to elderly patients?

1. Kidney function

2. Cardiac function

3. Stroke risk

4. Liver enzymes

The correct answer is: Stroke risk

When prescribing antipsychotics to elderly patients, it is particularly important to closely monitor stroke risk. Elderly individuals are at an increased risk for cerebrovascular events, including strokes, when they are treated with antipsychotic medications. This risk is more pronounced with atypical antipsychotics, which have been associated with an elevated incidence of stroke-related complications in this age group. Factors contributing to this increased stroke risk include the underlying medical conditions often present in elderly patients, such as hypertension, diabetes, and a history of cardiovascular disease, as well as the potential for antipsychotics to affect blood pressure and create sedation, which can further elevate the risk of cerebrovascular events. Therefore, careful assessment and monitoring of the patient's clinical status, including any signs of stroke, are crucial when initiating or adjusting antipsychotic therapy. While monitoring kidney function, cardiac function, and liver enzymes is also important when managing elderly patients on medications, the specific emphasis on stroke risk arises from the significant consequences that can result from cerebrovascular incidents in this population.