Alzheimers Flashcards
(16 cards)
Which medicines can cause antimuscarinic effects used in dementia?
Antidepressants (amitriptyline, paroxetine)
Antihistamines (chlorphenamine, promethazine)
Antipsychotics (olanzapine, quetiapine)
Urinary antispasmodics (solfenacin, tolteradine)
What are the 3 acetylcholinesterase inhibitors?
Rivastigmine
Donepezil
Galantamine
What is the first line treatment for mild/moderate Alzheimer’s disease?
If these are not tolerated/contraindicated what do you use?
Acetylcholinesterase inhibitors monotherapy
Memantine in moderate
What drug class is memantine?
NMDA receptor antagonist
What is the first line treatment for Alzheimer’s in severe disease?
Memantine
When would you add on memantine for a patient already taking an acetylcholinesterase inhibitor?
When they develop moderate to severe disease
What treatment do you give to a patient with mild to moderate Lewy body dementia?
First line rivastigmine or donepezil
Galantamine if above not tolerated
Memantine if above contraindicated or not tolerated
When can you give drug treatment for vascular dementia?
If they have co-morbid PD dementia, Alzheimer’s, LB dementia
Which two conditions are drug treatment for dementia/cognitive decline not recommended in?
Frontotemporal dementia and MS cognitive decline
When would you use antipsychotics in dementia?
Risk of hurting themselves or others
Hallucinations/agitation/delusions causing patient severe distress
What is the MHRA alert for antipsychotics in dementia?
Increased risk of stroke and small increased risk of death in elderly patients.
How often should use of antipsychotics be reviewed?
At least every 6 weeks
When should antidepressants be used?
Reserved for pre-existing severe mental health issues
What conditions are acetylcholinesterase inhibitors cautioned in?
Asthma
COPD
What serious side effect can galantamine cause? What if this occurs?
Steven-Johnsons syndrome
Counsel patients to stop taking immediately and get medical advice ASAP
What condition can rivastigmine be used for apart from Alzheimers?
Dementia in Parkinson’s Disease
