Chapter 4 - Dementia

Question 1

What are the 5 main types of dementia?

Answer 1

• Alzheimer’s dementia
• vascular dementia
• frontotemporal dementia
• Lewy-body dementia
• Parkinson’s disease with dementia

Question 2

What is the most common type of dementia?

Answer 2

Alzheimer’s disease dementia

Question 3

Which drugs can be used for the treatment of Alzheimer’s dementia?

Answer 3

Donepezil
Rivastigmine
Galantamine
Memantine

Question 4

What is first line pharmacological treatment for Alzheimer’s dementia?

Answer 4

Acetylcholinesterase Inhibitors

Question 5

Which neurotransmitter in the brain has been shown to be decreased in patients with Alzheimer’s dementia?

Answer 5

Acetylcholine

Question 6

Why should Acetylcholinesterase Inhibitors be initiated at a lose dose?

Answer 6

Dose related cholinergic effects can occur include:

arrythmias
Hallucinations
Diarrhoea

Question 7

Which AchI is also licensed for slowing down dementia progression in Parkinson’s disease?

Answer 7

Rivastigmine

Question 8

Which AchI is available in a transdermal patch?

Answer 8

Rivastigmine

Question 9

What is the MOA of memantine?

Answer 9

Glutamate receptor antagonist

increasing evidence that malfunctioning of glutamatergic neurotransmission, in particular at NMDA-receptors, contributes to both expression of symptoms and disease progression in neurodegenerative dementia.

Question 10

If memantine is a glutamate receptor antagonists, which types of patients should we be more cautionate with when initiating memantine?

Answer 10

Those with a history of convulsions e.g epileptics

Question 11

When is memantine initiated in patients?

Answer 11

Moderate to severe dementia

Or when AchI are not tolerated