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Flashcards in 5 - Dementia Deck (25):
1

Rule out ______ meds

anticholinergic

2

What are examples of anticholinergic meds?

antiemetics, antihistamines, antimuscarinics, antipsychotics, TCAs

3

If delusions or hallucinations occur, it usually indicates what kind of dementia?

lewy body dementia

4

___ risk factors increase chance of dementia

CV
(diabetes, HTN, stroke, smoking, etc.)

5

What drug classes have evidence to reduce risk of alzheimers?

-antihypertensives (diuretics, ACEi, ARB, BB)
-diuretics

6

What are other things to prevent dementia?

-MIND diet
-exercise

7

Vitamin B may be beneficial to prevent dementia only if ____ levels are elevated

homocysteine

8

What decrease on the MMSE scale is considered beneficial?

An annual decrease of less than 2 points on MMSE scale while on drug therapy = beneficial

*BUT MMSE is a poor indicator for individual response so must develop personal goals with patient and caregiver

9

Monitor for effects ___ weeks after starting or changing meds

2

10

What are the cholinesterase inhibitors?

donepezil, rivastigmine, galantamine

11

Which ChEi can be used in all severities?

donepezil

12

Which ChEi comes as a patch?

rivastigmine

13

What is memantine?

NMDA receptor antagonist - blocks glutamate-induced neuronal excitotoxicity (final pathway in neuronal death)

14

What severity is memantine used for?

only moderate-severe

15

Is ginkgo biloba good?

no consistent evidence of benefit

16

Key points for vascular dementia?

-control HTN (< 140/80 mmHg)
-add a lipid lover agent for dyslipidemias

17

How can ChEi affect those with parkinsons?

can increase parkinson-like features such as tremor

18

____ can be used for sleep or agitated behavior (associated with sun-downing)

trazodone

19

If BZD is required, which ones do you want to use?
Why?

LOT

-lorazepam
-oxazepam
-temazepam

*choose from these 3 because they have no active metabolites

20

Which ChEi has lowest risk for drug interactions?

rivastigmine

21

Which ChEis need to be taken with food?

rivastigmine and galantamine

*donepezil is with or without food

22

Which ChEi require adjustment for renal failure?

NONE

23

Does memantine require adjustment for renal failure?

yes

24

_____ also has less incidence of DIs

memantine

25

which gender is more at risk for AD

females

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