dementia

Question 1

what is dementia and different types

Answer 1

progressive syndrome characterised by cognitive and behavioural changes
- change in personality
- communication problems
- inability to carry out daily tasks
- memory loss

alzheimers - most common type of dementia
vascular dementia (due to cerebrovascular disease)
dementia with lewy bodies
mixed dementia
frontotemporal dementia

DEMENTIA - ALLEVIATED BY INCREASING ACH - treated using acetylcholinesterase inhibitors

Question 2

Dementia treatment

Answer 2

for all types:
mild to moderate dementia - acetylcholinesterase inhibitors
- donepezil (NMS)
- rivastigmine (GI SEs)
- galantamine (stevens-johnson syndrome)

moderate to severe dementia - MEMANTINE

aggravation - antipsychotics
- only offered if non drug tried or at risk of harming themselves or others and severe distress
- MHRA reported increased risk of stroke + small risk of death in elderly dementia patients on anti-psychotics
- AVOID in dementia with lewy bodies + Parkinson’s disease as can worsen motor features

acetylcholinesterase inhibitors & memantine - NOT RECOMMENDED in FRONTOTEMPORAL DEMENTIA

Question 3

side effects

Answer 3

increased ACh - PARASYMPATHETIC EFFECTS (rest, digest, secrete)

D - diarrhoea
U - urinary incontinence
M - muscle weakness
B - bradycardia
B - bronchospasm
E - emesis (vomiting)
L - lacrimation (producing tears)
S - salivation