Dementia Flashcards
Which medications are used in dementia?
Donepezil, Galantamine, Rivastigmine.
These are all acetylcholineesterase inhibitors.
Which type of dementia is Rivastigmine used for?
Lewy-Body dementia
Side effects of acetylcholinesterase inhibitors
Nausea, vomiting, diarrhoea, muscle cramps, insomnia, bradycardia
When is Memantine used?
Moderate–severe Alzheimer’s disease.
What drug class is Memantine?
NMDA- type glutamate receptor antagonist.
What medication is given to patients with bradycardia and dementia?
Memantine (As it is not an acetylcholinesterase inhibitor)
What does BPSD mean?
Behavioral and psychological symptoms of dementia (BPSD)
Neuropsychiatric disturbances such as agitation, aggression, depression, and apathy.
Up to 97% of community-dwelling patients with dementia and has a significant impact on prognosis.
What is the step wise management of BPSD?
1st line = Memantine
2nd line = Citalopram (to help with anxiety)
3rd line = Risperidone (only if the other medications have not worked to help with anxiety)
What is monitored in patients taking citalopram and why?
ECG - looking at the QT interval
Citalopram carries a high risk of prolonged QT interval
What is the main risk that Risperidone used in elderly patients carries?
Stroke risk is increased by 4x
How is Alzheimer’s diagnosis reached?
CT head showing cerebral atrophy
Which scan shows Lewy Body dementia?
PET brain scan - they show reduced dopamine transporter uptake in the brain.
