Dementia Flashcards

1
Q

What is dementia

A

Dementia is a progressive and irreversible syndrome characterised by impaired mental function. Alzheimer’s disease is the most common cause of dementia and symptoms include problems with memory, concentration and problem solving

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2
Q

Non-cognitive symptoms include

A

behavioural problems and difficulties with activities of daily living.

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3
Q

Drug therapy for Alzheimer’s

A

should be initiated by a specialist and assessment of their effectiveness should be carried out after around 3 months… this can be difficult since the disease may have deteriorated in this time.

  • If there is no apparent benefit but disease worsens significantly upon stopping then consider restarting
  • Donepezil, Galantamine + Rivastigmine are Acetylcholinesterase Inhibitors (AChEI) used to treat symptoms of mild-moderate dementia due to Alzheimer’s
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4
Q

suitable alternative for patients with moderate Alzheimer’s when AChEI are contraindicated or not tolerated

A

Memantine is a suitable alternative for patients with moderate Alzheimer’s when AChEI are contraindicated or not tolerated. It can also be used treat severe symptoms

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5
Q

When are Acetylcholinesterase Inhibitors and memantine not recommended

A

Acetylcholinesterase Inhibitors and memantine are not recommended in patients with frontotemporal dementia or cognitive impairment caused by multiple sclerosis

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6
Q

Management of violence, aggression and extreme agitation (non-cognitive symptoms)

A

In cases of dementia associated with severe behavioural disturbance (if violence, aggression or agitation threatens safety of patient/others), give an antipsychotic drug or benzodiazepine. The Lowest effective dose should be used for the shortest time possible, with regular reviews at least every 6 weeks.

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7
Q

MHRA reported (2009)

A

an increased risk of stroke and a small increased risk of death when antipsychotic drugs are used in elderly patients with dementia

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