1. Dementia

Question 1

Dementia symptoms

Answer 1

• Difficulties thinking
• Language
• Orientation

Non-cognitive symptoms:
Psychiatric and Behaivoral problems
Mood changes, hallucinations

HOWEVER, offering an antipsychotic drug in these patients INCREASES risk of stroke and death. not recommended

Question 2

Dementia treatment

Answer 2

Mild to moderate
1st line: Acetylcholinesterase inhibitor (Donepezil)

Severe:
1st line: Memantine

Question 3

Acetylcholinesterase inhibitors mechanism of action

Answer 3

Acetylcholine is a parasympathetic neurotransmitter and this becomes inhibited with this drug.

Question 4

Aceytlcholinesterase inhibitors drugs serious side effects

Answer 4

Donepezil: Neuroleptic Malignant Syndrome

Galantamine: Serious Skin reactions
STOP at first sign of rash

Rivastigmine: GI problems.
If GI problems occur, withold and switch to patch

Question 5

Aceytlcholinesterase inhibitors side effects

Answer 5

May also cause a build of acetylcholine –> cholinergic effects

D - diarrhoea
U - urination
M - muscle weakness, miosis (small pupils)
B - bronchospasm

B - bradycardia
E - emesis
L - lacrimation (tears)
S - salivation

cholinergic effects are opposite to antimuscarinic effects