NERVOUS SYSTEM -DEMENTIA Flashcards

1
Q

What is alzheimer’s disease?

A

Dementia is brain damage by diseases such as Alzheimer’s of Parkinson’s

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2
Q

What is 1st line drug treatment class for mild to moderate alzheimer’s?

A

Acetylcholinesterase inhibitor
donepezil hydrochloride, galantamine, or rivastigmine

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3
Q

What are 3 examples of Acetylcholinesterase inhibitor?

A

Donepezil, rivastigmine and galantamine

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4
Q

What drug is given for patients with mild to moderate dementia with Parkinsons?

A

Rivastigmine

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5
Q

What is an alternative to Acetylcholinesterase inhibitor?

A

Memantine

Used if disease more severe- by primary care

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6
Q

What is drug treatment used in SEVERE dementia?

A

Memantine

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7
Q

What drug class is memantine?

A

NMDA receptor antagonist

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8
Q

What are 4 symptoms of dementia?

A

Memory loss

Difficulty thinking

Language issue

Orientation

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9
Q

What are some non-cognitive symptoms of dementia?

A

Psychiatric + behaviour issues

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10
Q

What is an MHRA warning regarding Anti-psychotics in elderly patients with dementia?

A

Higher risk of stroke + death in elderly

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11
Q

What is MOA of Acetylcholinesterase inhibitor?

A

Blocks Acetylcholinesterase enzyme
- prevents breakdown of acetylcholine

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12
Q

What is a RARE SE of donepezil?

A

neuroleptic malignant syndrome

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13
Q

What is a rare SE of galantamine?

A

serious skin reactions (SJS)

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14
Q

What is a rare SE of rivastigmine?

A

GI issues

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15
Q

What formulation of Rivastigmine is there reduced GI effects?

A

Transdermal

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16
Q

When should patients be counselled to stop ACHe inhibitors?

A

STOP if they see first sign of rash

17
Q

What to do if patients gets GI issues on rivastigmine?

A

WITHHOLD oral + switch to patch

18
Q

What are 8 SE of cholinergic drugs/ AChE inhibitors? (DUMBBELS)

A

Diarrhoea

Urination

Muscle weakness, miosis (small pupils)

Bronchospasm

Bradycardia (slow HR)

Emesis (vomit)

Lacrimation (tears)

Salivation

19
Q

What is non drug treatment for mild-moderate dementia?

A

structured group cognitive stimulation programme

Therapy

20
Q

Drugs with anti-muscarinic effects do what?

A

cause cognitive impairment

21
Q

What 2 type of dementias are AcHe inhibitors + Memantine NOT recommended in?

A

frontotemporal dementia

OR

cognitive impairment caused by multiple sclerosis.

22
Q

What is epilepsy?

A

Seizure caused by hyperexcitable cortical neurones firing rapid Action potentials

23
Q

What are the 3 types of epilepsy?

A
  1. Focal
  2. Generalised
  3. Absense
24
Q

What is 1st line tx for focal seizures? (2 drugs can be used)

A

Lamotrigine

OR

Levetiracetam

25
Q

Why are Lamotrigine OR Levetiracetam better in females

A

less risk of fetal harm

26
Q

What 3 parts is generalised seizures split into?

A
  1. Tonic- clonic
  2. Myoclonic
  3. Atonic, tonic
27
Q

What is 1st line tx for generalised seizures?

A

Sodium valproate - males OR females unable to have kids

28
Q

What is 1st line tx for generalised seizures in women?

A

Lamotrigine or Levetiracetam

29
Q

What is 1st line tx for absence seizures? (2 options)

A

Ethosuximide

Sodium valproate

30
Q

What is a recent MHRA warning regarding epilepsy medications?

A

Harm when switching between different products.

31
Q

When cannot you use anti-psychotics?

A

Not used in parkinsons, can be used in dementia

32
Q

1st line mild-mod or severe dementia with Lewy bodies?

A

donepezil or rivastigmine

Galantamine ONLY if above do not work