Nervous System Flashcards
What classes of drugs cause anti muscarinic side effects?
Anti-depressants (amitriptyline, paroxetine)
Antihistamines (chlorphenamine, promethazine)
Antipsychotics (olanzapine, quetiapine)
Urinary spasmodics (solifenacin, tolterodine)
What is the first line treatment for mild to moderate Alzheimer’s disease?
Donepezil hydrochloride
Galantamine
Rivastigmine
(Acetylcholine esterases)
What drug is used to treat severe Alzheimer’s disease, or moderate Alzheimer’s when acetylcholine esterases are not tolerated?
Memantine hydrochloride - memantine can also be added to patients already recovering therapy with an acetylcholine esterase if they develop severe or moderate Alzheimer’s
What drug treatment should be initiated in patients diagnosed with mild to moderate dementia with Lewy bodies?
Donepezil hydrochloride or rivastigmine (unliscened indications)
Galantamine can be considered when first line medicines are not tolerated.
When should antipsychotics be started in dementia patients and what risks are associated?
Antipsychotics drugs should only be offered to patients with dementia if they are at risk of harming themselves or others, or experiencing agitation, hallucinations, or delusions.
MHRA has reported that there is an increased risk of stroke and death when antipsychotics are used in elderly patients with dementia.
What are the risks of starting antipsychotics in patients who have dementia with Lewy bodies or Parkinson’s dementia?
Antipsychotics may worsen motor features and in some cases cause severe antipsychotic sensitivity reactions.
Donepezil
- When should doses be given?
- Cautions
- Side effects
- At bedtime
- Asthma, COPD and susceptibility to peptic ulcers
3.
What side effect if galantamine should patients/carers be advised of?
Serious skin reactions
Inc Steven Johnson’s syndrome - manufactured advises to discontinue at first sign of a rash
