Dementia

Question 1

What is dementia?

Answer 1

Progressive clinical syndrome of deteriorating mental function, significant enough to interfere with activities of daily living

Question 2

What are the risk factors of dementia?

Answer 2

Age, mild cognitive impairment, learning difficulties, genetics, CVD disease risk factors, Parkinson’s

Question 3

What are some non-pharmacological treatment of the cognitive symptoms of dementia?

Answer 3

• Structured group stimulation programme
• Group reminiscence therapy
• Cognitive rehabilitation/occupational therapy

Question 4

What are the pharmacological treatments of the cognitive symptoms of dementia?

Answer 4

• Donepezil HCl
• Galantamine
• Rivastigmine
• Memantine HCl

Acetylcholinesterase inhibitors

Question 5

What type of inhibitor is Donepezil and what is it’s dose and metabolism pathway?

Answer 5

Reversible inhibitor of acetylcholinesterase

5mg OD for one month, inc if needed to 10mg OD
- Given at bedtime

CYP450 system

Question 6

What type of inhibitor is Galantamine and what is it’s dose and patient advice?

Answer 6

Reversible inhibitor of acetylcholinesterase

Twice daily dozing

Serious skin resctions

Question 7

What type of inhibitor is Rivastigmine and what is its dose

Answer 7

Reversible non-competitive inhibitor of acetylcholinesterase

Twice daily dosing

Question 8

What class of drug is Memantine HCl and what is it’s dose?

Answer 8

Glutamate receptor antagonist

Initially 5mg OD, inc in steps of 5mg at weekly intervals to max 20mg daily

Question 9

When is drug treatment offered to patients with non-cognitive symptoms?

Answer 9

When they are at risk of harming themselves or others OR
they are experiencing symptoms that are causing severe distress

Question 10

What is the only drug licensed for non-cognitive symptoms of dementia and what is its indication

Answer 10

Risperidone, for patients with SEVERE non-cognitive symptoms with are causing significant distress