Pharm Tx of Dementia

Question 1

Cholinesterase inhibitors

Answer 1

Mainstay of AD symptomatic treatment
Do not alter natural hx of disease
Ex: donepezil, galantamine, rivastigmine
Adverse effects: GI common, bradycardia and syncope serious

Question 2

Memantine

Answer 2

Non-competitive NMDA-R antagonist
Blocks the pathological activity of glutamate, but allows for physiologic function
Only use it in moderate to severe dementia
Not covered by pharmacare

Question 3

Antipsychotics

Answer 3

Risperidone, aripiprazole and olanzapine all have evidence
Quetiapine more for sleep issues because of sedation
Side effects: metabolic syndrome, PD symptoms, falls, sedation

Question 4

Antidepressants used in dementia

Answer 4

SSRIs (citalopram, escitalopram, sertraline)
SNRIs (venlafaxine)
NDRIs (bupropion)
Mirtazapine
Trazodone