Dementia Qs

Question 1

What antipsychotics can you give in PD psychosis?

Answer 1

1. Clozapine
2. Quetiapine

Avoid butyrophenone or phenothiazines as they make motor symptoms worse

Question 2

PD treatment

Answer 2

1. Levodopa
2. DA - P, R, R
3. MAOIb - S, R, S

Question 3

L-Dopa: SE

Answer 3

Low bp - postual hypotension
Dyskinesia
On-off (motor fluctuations)
Pyschiatric - impulse control, sudden onset sleep, hallucinations
Anorexia
RED URINE

Question 4

Non-ergot derived DA

1st line: motor symptoms do NOT affect QOL

Answer 4

Pramipexole
Ropinirole
Rotigotine (patch only)

Question 5

Ergot- derived DA

2nd line

Answer 5

Bromocriptine
Cabergoline
Pergolide

Question 6

MOAI b

Motor symptoms do NOT affect QoL

Answer 6

o Seligiline
o Rasagiline
o Safinamide

Question 7

Which MAOib causes alopecia

Answer 7

Seligiline

Question 8

Which MAO-B inhibitor is preferred over the other and why?

Answer 8

Rasagiline is preferred
- Because Selegiline can cause hallucination and insomnia

Question 9

Selegiline: metabolism

Answer 9

Amphetamine is one of its metabolites
- warning: driving

Question 10

What time should the last dose of selegiline be taken and why?

Answer 10

The last dose should be taken before 1 pm to avoid insomnia and hallucinations
So best to take it in the morning

Question 11

MAO-bi: interactions

Answer 11

• Drugs that cause hypertensive crisis
• Tyramine rich food

Question 13

MAO-bi: hypertensive crisis

Answer 13

OTC
- Pseudoephedrine
- phenylephrine
- xylometazoline, oxymetazoline (OTC interactions: nasal decongestants)

Other
- A/ NA
- Methylphenidate, amphetamines, B2 agonists

Question 14

COMTi: indications

Answer 14

Adjunct to levodopa in “end of dose” motor fluctuations.

Question 14

COMTi: examples

Answer 14

Entacapone
Tolcapone
Opicapone

Question 15

Entacapone: SE

Answer 15

Red-brown urine

Question 16

Which COMTi has highest risk of hepatotoxicity?

Answer 16

Tolcapone