dementia Flashcards
What are the classification of dementia?
alzheimers
vascular
lewy body
What is the treatment for alzheimers?
mild to moderate - AChEi
moderate- memantine (mono)
severe- meantine (mono) or can be added to AChEI
what is the difference between alzheimers, vascular and lewy body dementia
memory loss is more prominent in early alzheimers and in early lewy body hallucinations are more prominent.
vascular dementia - caused by blood clots
What is the treatment for lew body dementia?
> mild to moderate : Donepezil or rivastigmine
Galantamine – only if donepezil & rivastigmine not tolerated
severe: Donepezil or rivastigmine
ANY: Memantine – if AChEi not tolerated (or contraindicated)
What is the treatment for vascular dementia
ONLY consider AChEi /memantine if there’s also suspected Alzheimer’s disease, Parkinson’s dementia or dementia with Lewy bodies.
What is parkinsons dementia?
- When Parkinson’s disease develops into dementia.
- If they have had Parkinson’s symptoms for at least a year before any dementia symptoms, the condition is known as Parkinson’s disease dementia.
What is dementia with lewy body?
If symptoms of dementia develop first, and then motor symptoms, the condition is known as “dementia with Lewy bodies” (DLB)
What is the treatment for parkinsons dementia?
Mild – moderate - AChEi
Severe- AChEi
Only if AChEi contraindicated or not tolerated Consider memantine
What are the example of AChEi?
donepezil
rivastigmine
galantamine
What are the SE of AChEi?
Nausea
appetite decreased
arrhythmias - (galan+rivast)
Hepatotoxicity (can occur)
What is the SE of memantine?
Balance impaired, dizziness, drowsiness
Constipation
Dyspnoea
Headache
Hypersensitivity
hypertension
what are the cautions for elderly pts when STOPP criteria would apply (AChEi) ?
if pts develop bradycardia or heaty block where heart beats <60b/min stop
What is the advice on treatment cessation for alzheimers?
Do not stop AChE inhibitors in people with Alzheimer’s disease because of disease severity alone.
