An 82-year-old woman who lives alone is seen in clinic after her third fall in 6 months; the latest fall caused a wrist fracture. She reports feeling unsteady when she gets out of bed at night and when she stands up quickly. Her medications are lorazepam 1 mg at bedtime for insomnia, amitriptyline 25 mg at bedtime for neuropathic pain, furosemide 20 mg daily for ankle swelling started years ago, ramipril 5 mg daily and acetaminophen as needed. She has no history of heart failure and no known allergies. On examination, her cognition is intact (MoCA 27/30), there is no focal neurological deficit, and her gait is slow and wide-based. Serum sodium is 138 mmol/L (135-145) and creatinine is 78 µmol/L (45-90).
| Heart rate | 76/min, regular |
| Respiratory rate | 16/min |
| Temperature | 36.7 °C |
| O2 saturation | 97%, room air |
| Blood pressure | 142/80 mm Hg supine; 117/72 mm Hg after 3 minutes standing |
Question 1 of 39
Which of the following are the most appropriate medication changes at this visit to reduce her risk of falls?
Select 2. (0 / 2 selected)
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