Medications Flashcards
1st line management for Alzheimer’s disease
Acetylcholinesterase inhibitors
name 3 Acetylcholinesterase inhibitors (AchE-I)
Donepezil
Galantamine
Rivastigmine
medication that is both a butyrylcholinesterase + Acetylcholinesterase inhibitors
Rivastigmine
2nd line management for Alzheimer’s disease
Memantine
mechanism of Memantine
NDMA receptor antagonist
management of vascular dementia (3)
- vascular risk prevention
- statins
- aspirin
Management of Lewy Body Dementia
Rivastigmine
management of Frontotemporal dementia
No pharmacological agents available
side effects of AchE-I
due to increased cholinergic activity
- nausea, vomiting, diarrhoea
- insomnia
- dizziness
- urinary incontinence
indication for Memantine
- monotherapy for people with moderate AD that are intolerant to AchE-I
- severe AD
- taken in combo with AchE-I in those with moderate or severe disease
safest choice of AchE-I for those with CVD?
rivastigmine
side effects of AchE-I + NMDA receptor antagonists
- diarrhoea
- dizziness
- anorexia/weight loss
- n+v
- insomnia
common side effects of Sertraline (6)
- dry mouth
- reduced sex drive
- impotence
- difficulties orgasming
- drowsiness
- GI upset - mild nausea
group of antidepressants with greatest risk of overdose
TCAs
group of antidepressants that are irreversible
MAOI
monitoring required for patients on antidepressants
2 to 4 weekly in first 3 months… then at longer intervals if the response is good
when is monitoring at 1 week following commencing antidepressants required
high risk of suicide
or
< 30 years old
when should patients remain on antidepressants potentially lifelong
> 5 episodes of depression
or
2 episodes in last few years
which antidepressant is best in IHD/post MI
- sertraline
antidepressants that have an increased risk of GI bleedingq
SSRIs
important drug counselling for taking an SSRI
increased anxiety and agitation after starting
2 SSRIs associated with dose dependant QTc interval prolongation
- Citalopram
- Escitalopram
common SE of TCAs
- drowsiness
- dry mouth
- blurred vision
- constipation + urinary retention
2 examples of SNRI and what is the mechanism of action
- Duloxetine
- Venlafaxine
inhibits the reuptake of noradrenaline + serotonin at the synaptic cleft leading to increased concentrations of these neurotransmitters
