Question

scenario: a patient with alzheimers disease is on donepezil but develops bradycardia. question: what is the best course of action? discontinue donepezil and monitor the heart rate. reduce the dose of donepezil. add a beta - blocker to manage the heart rate. switch to memantine.

Explanation:

Donepezil can cause bradycardia. When a patient on donepezil develops bradycardia, the first step is to discontinue the medication causing the adverse effect (donepezil) and monitor the heart rate to assess improvement and guide further management. Reducing the dose may not fully address the bradycardia risk, adding a beta - blocker (which also slows heart rate) is contraindicated, and switching to memantine is not the immediate best action for bradycardia due to donepezil; discontinuing the offending agent first is key.

Answer:

Discontinue donepezil and monitor the heart rate.