Dementia

Question 1

5 As of Alzheimers

Answer 1

Aphasia -inability to express oneself through speech
Amnesia- memory loss
Anomia- inability to rem names
Agnosia- inability to recognize object
Apraxia- misuse of objects, failure to recognize

Question 2

Exam used to assess cognitive impairment.

Answer 2

Minimental Scale Exam MMSE

Question 3

Amyloid plaques are found in this tyoe of disease and deficient in what receptor?
This dementia is associated with psychosis.

Answer 3

Alzheimers dementia
Deficient in Acetylcholine.
Levy body dementia

Question 4

DOC for Alzheimer dementia?

For Levy Body dementia?

Answer 4

Donepezil

Rivastigmine

Question 5

Symptoms of Alzheimers.

Answer 5

Memory loss, disorientation, impaired executive functions, behavioral and psychotic disturbances, depression and inability to care for self

Question 6

Risk factors of Alzheimers.

Answer 6

Age, family history, head injury, cardiovascular risk factors

Question 7

Oldest drug for Alzheimers, non selective and limited use due to what?

Answer 7

Tacrine SE: hepatotoxicity

Question 8

Types of drugs for Alzheimers disease and specificity.

Answer 8

Reversible Acetylcholinesterase inhibitors:
Specific: Donepezil and Rivastigmine
Non specific selective: Galanthamine

Question 9

Donepezil SEs

Answer 9

CNS effects, fatigue insomia headache muscle cramps anorexia difficulty urinating

Question 10

Drug interactions for Donepezil.

Answer 10

Inc. toxicity by CYP2D6 and CYP3A4 inhibitors: Paroxetine Eryth Prednisone GFJ Nefazodone
Dec. efficacy by CYP2D6 and CYP3A4 inducers: Carb, pheny, Rifampin

Question 11

MOA of Rivastigmine.

Answer 11

Inhibits non specific butylcholinesterase, Reversible AchE or centrally selective arylcarbamate AchEi

Question 12

Why is Rivastigmine referred to as pseudo-irreversible AchEi?

Answer 12

Has short half life of 2h but is able to inhibit AchE up to 10h, because of slow dissociation of carbamate enzyme.

Question 13

Rivastigmine SEs.

Answer 13

Weight loss due ti reduced appetite nauseated abdominal pain depression agitation confusion drowsiness dizziness weakness trembling sweating malaise convulsions (rare)

Question 14

Rivastigmine dosing. And DI.

Answer 14

Initial 1.5mg BID can be doubled 3mg BID after 30 days which is minimum effective dose.
Avoid antipsychotics.

Question 15

Dosing for Donepezil.

Answer 15

Initial 5mg/day, target 10mg/day adjust after 4 weeks

Question 16

MOA of Galanthamine

Answer 16

Selective non specific, competitive reversible AchEi enhances Ach on nicotinic receptors

Question 17

Galanthamine SEs

Answer 17

N and v abd pain diarr indigestion dec. appetite wt loss headache dizziness tiredness sleepiness sleeplessness confusion runny nose UTI, falling

Question 18

Galanthamine dosing

Answer 18

16-32mg BID

Question 19

This Alzheimers drug is a NMDA antagonist

Answer 19

Memantine

Question 20

Delirium symptoms

Answer 20

Acute agitation, hallucination, extreme excitement and disorientation

Question 21

Acute psychosis cause by alcohol withdrawal

Answer 21

Delirium tremens