Optimized Prescribing with Seniors


A joint communication of the Alberta Medical Association and the College of Physicians & Surgeons of Alberta, these articles are written by physicians for physicians prescribing in the care of older patients.

  • View the AMA/CPSA OPS publication schedule for 2024

Archived articles

The archive below includes the six most recent Optimized Prescribing with Seniors articles. For older issues, please contact the AMA web team at webmaster@albertadoctors.org

Evaluating the likelihood of emerging acute or decompensated heart failure – Part 2

Kanwar, a 72-year-old male with acute decompensated heart failure, was initiated on Lasix. Though his symptoms improved, his energy levels remained suboptimal. An echocardiogram was requested and the workup for contributing factors was unremarkable.

Evaluating the likelihood of emerging acute or decompensated heart failure – Part 1

Kanwar is 72 and five years ago he suffered a myocardial infarction and received a stent. His medical history includes atrial fibrillation and hypertension. Recently Kanwar reported experiencing shortness of breath, especially during activities like walking at the mall. Fatigue sets in quickly, necessitating longer rest periods. He's also been less inclined to exercise or engage in social activities.


Beryl is 76 years old and attends her family doctor as she has been feeling tired. She reports that over the last year she has been woken several times at night by the urge to pass urine and finds it difficult to get back to sleep. Why is Beryl waking overnight to go to the toilet and how can this be improved?

Constipation in the elderly

Ms. Oddring is 83 and presenting with a three-to-four-year history of intermittent fecal incontinence/seepage. An abdominal exam shows only mild distension and digital rectal exam is unremarkable. An abdominal x-ray shows moderate fecal loading. How can constipation be recognized and managed effectively in this population?

Focus on Parkinson’s disease – Part 2 (advanced disease and psychosis)

George is 72 and a retired teacher. He has a 10-year history of Parkinson’s disease with motor fluctuations including end of dose wearing off, for which he receives pramipexole and entacapone; and peak dose dyskinesias (involuntary movements), for which he receives amantadine.

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OPS Physician Coordinator

Dr. Lesley Charles, OPS Physician CoordinatorDr. Lesley Charles, MBChB, CCFP, is a geriatric physician at the Grey Nuns Community Hospital. Her areas of clinical interest include dementia, delirium and treatment of osteoporosis. She obtained her medical education at the University of Edinburgh then completed her family medicine residence at the University of Alberta.

Dr. Charles is an associate professor with the Department of Family Medicine (Division of Care of the Elderly) at the University of Alberta. Her research interests include the Care of the Elderly Program; Decision-Making Capacity Assessment and Implementation and Sustainability Framework; Care of the Elderly Graduates Research; Developing and the Effects of Introducing Core Competencies; and Caregivers

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