Dementia

Question 1

Dementia diagnosis

Answer 1

signs of cognitive dysfunction >6months
mh concurrent depression and anxiety
*NOT a normal consequence of aging!

Question 2

Donepezil/ Aricept

Answer 2

Class: centrally acting reversible Ach-esterase Inhibitor
Indic: Alzheimers (MC), (off label: Lewy body dementia, vascular dementia)
SE: bradycardia, hypotension, inc urination, N/V, inc GI motility
may increase vocabulary and language in autism

Question 3

Rivastigmine/ Exelon

Answer 3

Class: centrally acting reversible Ach-esterase inhibitor
Char: PO/ transdermal patch (patch has dec SE profile)
Indic: mild Alzheimers, dementia dt Parkinsons
most benefit seen in early onset dementia or dementia with hallucinations/delusions
SE: bradycardia, hypotension, inc urination, N/V, inc GI motility

Question 4

Galantamine/ Razadine

Answer 4

Class: Ach-esterase inhibitor/ cholinergic
Indications: Alzheimers, vascular dementia, “brain enhancer” in brain damage

Question 5

Symptoms of Acetylcholine esterase inhibitor overdose:

What is the antidote?

Answer 5

N/V, salivation, sweating, bradycardia, hypotension, convulsions, circulatory collapse

Antidote: ATROPINE

Question 6

Memantine/ Namenda

Answer 6

MOA: 5-HT3 recetor agonist; D2 receptor agonist; NMDA glutamate receptor antagonist; nicotinic Ach receptor antagonist; inhibited prolonged Ca influx–> moderate dec in alzheimers progression

Indic: Alzheimers
SE: confusion, drowsiness, dizziness, insomnia, HA, agitation, hallucinations, vomiting, anxiety, increased libido