Dementia Flashcards

1
Q

What causes dementia?

A

Brain is damaged by diseases such as Alzheimer’s, strokes or Parkinson’s

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2
Q

What are the cognitive symptoms of dementia?

A

Memory loss
Difficulties thinking
Language
Orientation

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3
Q

What are the non-cognitive symptoms of dementia?

A

Psychiatric and behavioural problems

Difficulties with daily activities

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4
Q

What is used to manage the cognitive symptoms of dementia?

A

Acetylcholinesterase inhibitors

NMDA glutamate receptor antagonists

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5
Q

What are the acetylcholinesterase inhibitors used for and what are they?

A

Donepezil

Galantamine

Rivastigmine

Used in mild-moderate Alzheimer’s disease

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6
Q

When should you stop galantamine?

A

At first appearance of skin rash

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7
Q

What are the NMDA antagonists used for and what are they?

A

Memantine for moderate-severe Alzheimer’s disease

Anticholinesterases are contraindicated in moderate or severe Alzheimer’s

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8
Q

What are the cholinergic side effects?

A

DUMB BELS

Diarrhoea
Urination
Muscle weakness
Bronchospasm

Bradycardia
Emesis
Lacrimation
Salivation

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9
Q

What are the antipsychotic drugs used for in dementia?

A

Management of severe non-cognitive symptoms causing distress ie immediate risk of harm to self or others

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10
Q

What is the MHRA advice for antipsychotics?

A

Clear increased risk of stroke and death when antipsychotics are used in elderly patients with dementia

History of stroke, TIA
Cerebrovascular disease risk factors

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11
Q

What do you use for extreme violence, aggression and extreme agitation?

A

Oral benzodiazepines or antipsychotics

If IM needed for behavioural control - haloperidol, olanzapine, lorazepam

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12
Q

What do you use for dementia with Lewy Body (Parkinson’s)?

A

Acetylcholinesterase inhibitors - rivastigmine

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13
Q

What acetylcholinesterase inhibitor increases the risk of neuroleptic malignant syndrome?

A

Donepezil

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14
Q

What acetylcholinesterase inhibitors are used in Parkinson’s disease and cause GI disturbances?

A

Rivastigmine

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