Dementia medication

Question 1

What are the two classes of drugs used in treatment of Alzheimer’s disease?

Answer 1

AChE inhibitors

NMDA blockers

Question 2

Name 3 AChE inhibitors

Answer 2

Donepezil
Rivastigmine
Galantamine

Question 3

Name 1 NMDA blocker

Answer 3

Memantine (partial antagonist)

Question 4

Name a contraindication for Rivastigmine

Answer 4

Severe liver impairment

Question 5

Name a contraindication for Galantamine

Answer 5

Severe renal or hepatic dysfunction

Question 6

Name 3 common side effects of AChE inhibitors

Answer 6

Diarrhoea
Muscle cramps
Fatigue
NaV
Insomnia

Question 7

Name 2 rare side effects of AChE inhibitors

Answer 7

Seizures
Cardiac conduction disturbances
Psychiatric disturbances
-Aggression, hallucinations, agitation

Question 8

Name 2 DDIs of AChE inhibitors

Answer 8

Anaesthetics: Likely to potentiate succinylcholine-like muscle relaxation

CYP450: Donepezil is metabolised by CYP450 enzymes. Therefore, inducers and inhibitors will affect the serum levels of Donepezil.

Question 9

Name 2 CYP450 inhibitors

Answer 9

Quinidine
Isoniazid
Erythromycin
Clarithromycin
Fluoxetine

Question 10

Name 2 CYP450 inducers

Answer 10

Warfarin
Phenytoin
Rifampicin
Carbamazepine
Alcohol

Question 11

What is the indication for AChE inhibitors?

Answer 11

Symptomatic treatment of mild to moderate Alzheimer’s disease (MMSE 10-26)

Question 12

What is the indication for NMDA blockers?

Answer 12

Symptomatic treatment of severe Alzheimer’s disease (MMSE <10)

Question 13

Name 3 common side effects of Memantine

Answer 13

Dizziness
Headaches
Constipation
HTN

Question 14

Name 2 uncommon side effects of Memantine

Answer 14

Fungal infection
Confusion
Hallucinations
Gait abnormality
Cardiac failure