Pharm Wk 14 - Dementia

Question 1

What does cholinesterase inhibitors do?

Answer 1

they block the metabolism of acetylcholine within the synaptic cleft resulting in increased acetylcholine and increased cholinergic transmission

Question 2

what are the mainstays of treatment for cognitive and function symptoms of most causes of dementia?

Answer 2

cholinesterase inhibitors

Question 3

While clinically detectable, the benefits of cholinesterase inhibitors for Alzheimer’s disease are?

Answer 3

typically small to moderate

Question 4

Up to 68% of people with Alzheimer’s disease respond to cholinesterase inhibitors with

Answer 4

an initial period of cognitive stabilization (2–5 months) before continuing to decline at the pretreatment rate

Question 5

what is the only cholinesterase inhibitor indicated for all disease severities of Alzheimer’s disease and is also used in other neurological diseases that cause dementia

Answer 5

donepezil

Question 6

what are some adverse effects of donepezil?

Answer 6

diarrhea, nausea, vomiting, anorexia and/or weight loss

Question 7

what is the mechanism of action of the NMDA receptor antagonist memantine?

Answer 7

to block glutamate-induced neuronal excitotoxicity, a process that is implicated as a final common pathway in neuronal death

Question 8

memantine is not typically used as ? unless cholinesterase inhibitor therapy is contraindicated or has failed/adverse effects are intolerable

Answer 8

monotherapy

Question 9

Memnatine is more often used in?

Answer 9

combination with cholinesterase inhibitors to augment the response in severe disease

Question 10

Responsive behaviours falls within 3 contexts which are:

Answer 10

• due to dementia itself
• due to previous mental health conditions
• due to sudden changes or triggers

Question 11

what is responsive behaviours?

Answer 11

actions or reactions that people with dementia may show due to changes in their brain or environment

Question 12

Many patients in the early stages of dementia experience what?

Answer 12

depression

Question 13

What are less likely than tricyclic antidepressants to cause anticholinergic side effects or to worsen orthostatic hypotension, which are common and problematic in this population

Answer 13

SSRIs (except for paroxetine)

Question 14

what is generally reserved for the treatment of agitation or psychosis in patients with dementia when symptoms are severe, dangerous, or cause clinically significant distress

Answer 14

antipsychotics

Question 15

What antipsychotics have the most evidence in this population?

Answer 15

Risperidone and olanzapine