Cogentin dose in adults is:

• A. Increase dose in hepatic impairment
• B. No adjustment needed but use caution
• C. Stop in elderly
• D. Dose reduction in renal impairment

Answer: (B)

Benztropine is an anticholinergic used to treat Parkinsonian symptoms and drug-induced extrapyramidal effects. In adults, standard dosing is generally appropriate even when there is hepatic or renal impairment, because these organ dysfunctions do not usually require routine dose reductions for this medication. The important point is to use caution: benztropine can cause a range of anticholinergic side effects—dry mouth, constipation, urinary retention, blurred vision, confusion, and delirium—especially in older adults or those with cognitive impairment. Therefore, while no formal dose adjustment is needed, clinicians should start at the lowest effective dose and monitor closely for adverse effects in susceptible patients.