Dementia Flashcards
What are the two causes of dementia?
- Vascular dementia e.g. from a CVA
- Build up of proteins
What’s the treatment of cognitive dementia?
Secondary prevention following a CVA e.g. clopidogrel and a statin
How does the build up of proteins lead to dementia?
There is a reduction in neurotransmitter acetylcholine. The build up of proteins reduces the amount available.
What are the two types of things acetylcholine effects
Rest and digest
Cognition
What’s the treatment for dementia
Acetylcholinesterase inhibitors e.g. Donepezil, Galantamine, Rivastigme
Glutamate receptor antagonist e.g. Memantine
How does glutamate receptor antagonists help in dementia?
In dementia the body can make too much glutamate and damage nerve cells. These drugs makes it harder to dock onto the receptor.
If acetylcholine effects the rest and digest process, what kind of side effects will we see from the acetylcholinesterase inhibitors?
Reduced heart rate (Bradycardia)
Increased salivation
Increased motility (diarrhoea)
What types of drugs should be avoided in patients with dementia?
Anticholinergic drugs
What are examples of anticholinergic drugs
Antidepressants
Antipsychotics
Antihistamines
What are the co-morbidities of dementia?
Depression and anxiety
Agitation, aggression, distress and psychosis
Sleep disturbances
In someone with dementia, how do we treat depression?
- Non pharmacological
- If severe then 1st line SSRI’s
In someone with dementia, how do we treat agitation, aggression, distress and psychosis?
If they are at risk of harming themselves or others, experiencing severe hallucinations agitation or delusions then they can be treated with antipsychotics
What is the MHRA warning when using antipsychotics in patients with dementia?
Increased risk of stroke and falls
In patients with dementia, how do we treat sleep disturbances?
Non drug treatment to avoid mental cloudiness and sedation
What are the two licensed antipsychotics in dementia?
Haliperidol and Risperidone
