Dementia Flashcards
What causes dementia?
Brain is damaged by diseases such as Alzheimer’s, strokes or Parkinson’s
What are the cognitive symptoms of dementia?
Memory loss
Difficulties thinking
Language
Orientation
What are the non-cognitive symptoms of dementia?
Psychiatric and behavioural problems
Difficulties with daily activities
What is used to manage the cognitive symptoms of dementia?
Acetylcholinesterase inhibitors
NMDA glutamate receptor antagonists
What are the acetylcholinesterase inhibitors used for and what are they?
Donepezil
Galantamine
Rivastigmine
Used in mild-moderate Alzheimer’s disease
When should you stop galantamine?
At first appearance of skin rash
What are the NMDA antagonists used for and what are they?
Memantine for moderate-severe Alzheimer’s disease
Anticholinesterases are contraindicated in moderate or severe Alzheimer’s
What are the cholinergic side effects?
DUMB BELS
Diarrhoea
Urination
Muscle weakness
Bronchospasm
Bradycardia
Emesis
Lacrimation
Salivation
What are the antipsychotic drugs used for in dementia?
Management of severe non-cognitive symptoms causing distress ie immediate risk of harm to self or others
What is the MHRA advice for antipsychotics?
Clear increased risk of stroke and death when antipsychotics are used in elderly patients with dementia
History of stroke, TIA
Cerebrovascular disease risk factors
What do you use for extreme violence, aggression and extreme agitation?
Oral benzodiazepines or antipsychotics
If IM needed for behavioural control - haloperidol, olanzapine, lorazepam
What do you use for dementia with Lewy Body (Parkinson’s)?
Acetylcholinesterase inhibitors - rivastigmine
What acetylcholinesterase inhibitor increases the risk of neuroleptic malignant syndrome?
Donepezil
What acetylcholinesterase inhibitors are used in Parkinson’s disease and cause GI disturbances?
Rivastigmine
