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4. CNS > 4. Dementia > Flashcards

4. Dementia Flashcards

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1
Q

Alzheimer’s

What is it

A

Alzheimer’s disease destroys nerve connections in the brain,

making it progressively more difficult to do ordinary things like move around, swallow and feed yourself.

While the disease devastates the brain, it does not kill you.

Complications of the decline in brain function is what leads to death

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2
Q

Dementia

What is it

A

Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life.

Alzheimer’s is the most common cause of dementia.
60-80%

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3
Q

Dementia

Symptoms

Cognitive 4
&
non-cognitive 2

A

Cognitive: 4
Memory loss (difficulty remembering)
Difficulty thinking (lack of concentration)
Language ( can’t find the word)
Orientation (dates, days, where is home)

Non-cognitive 2
Difficulty with daily activities
Psychiatric and behaviour problems (aggression)

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4
Q

Dementia

types 5

A

Alzheimer’s disease. Alzheimer’s disease is the most common cause of dementia

Vascular dementia
Lewy body dementia
Frontotemporal dementia 45-65 age or younger
Mixed dementia

Dementia usually starts from 60+

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5
Q

Vascular dementia

Drug Tx

A

Drug Tx is NOT recommended

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6
Q

Tx in

Mild- moderate

Alzheimer’s

List drugs

A

Acetylcholinesterase inhibitors

donepezil

rivastigmine

galantamine

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7
Q

Acetylcholinesterase inhibitors

SE

(DUMB BELS)

A

DUMB BELS

diarrhoea
Urination ⬆️
Muscle weakness/cramps
Bronchospasm (SOB)

Bradycardia
Emesis (vomit)
Lacrimation (teary eyes)
Salivation/sweating

Anxiety; appetite decreased; arrhythmias; asthenia; dehydration; depression; diarrhoea; dizziness; drowsiness; fall; gastrointestinal discomfort; headache; hyperhidrosis; hypersalivation; hypertension; movement disorders; nausea; skin reactions; syncope; tremor; urinary incontinence; urinary tract infection; vomiting; weight decreased

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8
Q

Acetylcholinesterase inhibitors

List with 1 common SE

A

Donepezil

Galantamine

Rivastigmine

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9
Q

Which Drug (especially with concomitant antipsychotics)

causes this SE

Neuroleptic malignant syndrome

A

Donepezil

Neuroleptic malignant syndrome (NMS) is a life-threatening idiosyncratic reaction to antipsychotic drugs

characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction.

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10
Q

Which Drug

causes this SE

Skin rash

(Stevens-Johnson syndrome rash)

STOP IMMEDIATELY

A

Galantamine

The syndrome often begins with flu-like symptoms, followed by a red or purple rash that spreads and forms blisters. The affected skin eventually dies and peels off.

Stevens-Johnson syndrome is a medical emergency that requires treatment in hospital, often in intensive care or a burns unit.

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11
Q

Rivastigmine

The main reason from changing oral to patch is which SE?

A

GI disturbances

stop meds till problem resolved

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12
Q

Moderate - severe Alzheimer’s

Acetylcholinesterase inhibitors are

CI

What is the Tx

A

Memantine

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13
Q

If acetylcholinesterase inhibitors CI in patient with moderate Alzheimer’s give:

A

Memantine

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14
Q

What is

Oscillopsia

A

Oscillopsia is the sensation that the surrounding environment is constantly in motion when it is, in fact, stationary. Oscillopsia is usually a symptom of conditions that affect eye movement or the eye’s ability to stabilize images, especially during movement

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15
Q

Managment of

SEVERE

non-cognitive symptoms

In dementia (non-Lewy body)

(Psychic and behaviour problems )

A

Oral

Benzodiazepines

Or

antipsychotic

(If IM needed: haloperidol, olanzapine, lorazepam)

IV route only in EXCEPTIONAL circumstances

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16
Q

Managment of

SEVERE

non-cognitive symptoms

(Psychic and behaviour problems )

In Lewy body dementia associated with parkingsons disease

A

Acetylcholinesterate inhibitors

Rivastigmine

(Also used to treat cognitive symptoms)

As this is the ONLY acetylcholinesterate licensed in dementia with Parkingsons

17
Q

When to treat

Severe non-cognitive symptoms in dementia

A

Only in SEVERE that cause SIGNIFICANT DISTRESS or IMMEDIATE risk of harm to self or others

MHRA ⚠️
Increased risk of: 
Stroke
And
Death

In elderly pts

Assess benefit over risk & history of CVD

18
Q

this is the ONLY acetylcholinesterate inhibitor

licensed in dementia with Parkingsons

A

Rivastigmine

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