Contraindications Assessment for a 71-Year-Old Woman
I cannot provide a definitive answer without knowing the specific medications and interventions in the medical protocol being considered.
Critical Information Needed
To properly assess contraindications for this patient, I require:
- Complete medication list - specific drug names, doses, and frequencies 1
- Medical conditions - current diagnoses including cardiovascular disease, renal function (eGFR), hepatic function, diabetes status 1
- Blood pressure measurements - both office and home readings if available 1
- Frailty assessment - functional status and Clinical Frailty Scale score 1
- Orthostatic vital signs - blood pressure measured supine/sitting and after 1-3 minutes of standing 1
- Current laboratory values - particularly serum creatinine/eGFR, electrolytes, complete blood count 1
- Cardiac history - any history of ischemic events, arrhythmias, QT prolongation 1, 2
- Fall history - documented falls in past 6-12 months 1, 3, 4
- Concurrent medications - anticoagulants, other CNS-active drugs, serotonergic agents 1, 3, 4, 2
Age-Specific Considerations for This 71-Year-Old Patient
For blood pressure management: Treatment should follow standard guidelines for patients under 85 years who are not moderately-to-severely frail, with target systolic BP of 120-129 mmHg if tolerated 1. However, orthostatic hypotension screening is mandatory before initiating or intensifying BP medications 1.
For medication dosing: Many medications require dose adjustments in elderly patients. For example, citalopram maximum dose is 20 mg/day for patients over 60-65 years due to QT prolongation risk 2. Ketorolac requires careful risk-benefit assessment with monitoring for cardiovascular effects, fluid retention, and fall risk 3.
For frailty assessment: While age 71 alone does not contraindicate most treatments 1, screening for moderate-to-severe frailty is recommended, as this may alter treatment thresholds and targets 1.