CoE Flashcards
Which psychiatric medication should be avoided in patients with dementia? Why?
Antipsychotics have adverse reactions and increase mortality
What medication can cause irreversible parkinsonism in lewy body dementia?
Neuroleptics e.g. haloperidol
What is the mechanism of action of memantine?
NMDA receptor antagonist
Causes of delirium: (7)
P - pain I - infection N - nutrition C - constipation H - hydration
M - medication
E - environment
Why is haloperidol contraindicated in Parkinson’s?
It is a dopamine antagonist so will worsen symptoms
What is the PRISMA-7 questionnaire?
A questionnaire composed of 7 questions that assess frailty. A score of 3 or more indicates increased risk of frailty and a need for further clinical review.
What tool is used to assess risk of developing a pressure sore?
Waterlow score
What type of dementia would you consider in a middle aged adult with an insidious onset and personality changed?
Frontotemporal (pick’s disease)
Criteria for diagnosing orthostatic hypotension:
a) Drop in systolic of 20 or more
b) Drop to below 90 on standing even if drop is a decreased of less than 20
c) Drop in diastolic of 10 with symptoms
Definition of orthostatic hypotension:
Fall in BP of >20 systolic or >10 diastolic on standing
Exacerbating factors for orthostatic hypotension (6):
- exercise
- night-time
- after eating
- warm environment
- coughing
- post micrturition or defecation
Drugs that can cause orthostatic hypotension (9):
- Vasodilators
- Diuretics
- Negative inotropes
- Negative chronotropes
- Antidepressants
- Antipsychotics
- Opiates
- Levodopa
- Alcohol
8 causes of orthostatic hypotension:
- drugs
- chronic HTN
- volume depletion (dehydration, acute haemorrhage)
- sepsis (vasodilation)
- autonomic failure (diabetes, parkinson’s)
- prolonged bed rest
- adrenal insuffiency
- raised intrathoracic pressure
