Dementia and ACB Flashcards
(26 cards)
What are the common cognitive symptoms of dementia?
Memory loss, problems with reasoning and communication, personality changes, and difficulty with daily activities such as washing or dressing.
Which factors are considered modifiable risk factors for dementia?
Smoking, diabetes mellitus, lack of physical activity, and obesity.
What are the common types of dementia?
Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, mixed dementia, and frontotemporal dementia.
What is mild cognitive impairment?
Cognitive impairment that does not fulfill the diagnostic criteria for dementia.
What is the primary treatment approach for mild-to-moderate Alzheimer’s disease?
Monotherapy with acetylcholinesterase inhibitors (donepezil, galantamine, or rivastigmine).
What should be done if a patient with Alzheimer’s disease experiences moderate or severe symptoms while on an acetylcholinesterase inhibitor?
The addition of memantine should be considered.
What are the first-line drug treatments for mild to moderate dementia with Lewy bodies?
Donepezil or rivastigmine are recommended first-line.
What is the preferred treatment for Parkinson’s disease dementia?
Rivastigmine capsules are the only treatment with a UK marketing authorisation for mild or moderate Parkinson’s disease dementia.
What is the recommended approach for managing agitation, aggression, distress, and psychosis in patients with dementia?
Offer psychosocial and environmental interventions like counselling and pain management. Antipsychotics should only be used if there is a risk of harm or distress.
When should antidepressants be considered for patients with dementia?
Antidepressants should be reserved for patients with pre-existing severe mental health problems or those with severe depression or anxiety.
How should sleep disturbances in Alzheimer’s disease be managed?
Non-drug treatments like sleep hygiene education, exposure to daylight, and increasing physical activity should be prioritized. Melatonin should not be offered for insomnia in Alzheimer’s disease.
What are some non-drug treatments for dementia patients with cognitive symptoms?
Structured group cognitive stimulation programs, group reminiscence therapy, cognitive rehabilitation, and occupational therapy to support daily functional abilities.
What is anticholinergic burden?
Anticholinergic burden refers to the cumulative effect of taking multiple medications with anticholinergic properties, which increases the overall impact on the individual’s system, especially in older adults.
Why is anticholinergic burden particularly concerning in older adults?
It can increase the risk of cognitive impairment, falls, and other adverse health outcomes.
What is the primary way that anticholinergics work in the body?
Anticholinergics block the action of acetylcholine by binding to and inhibiting muscarinic receptors.
How do anticholinergics affect the central nervous system?
By blocking acetylcholine, anticholinergics can lead to memory impairment, cognitive dysfunction, and confusion, especially in older adults.
Why are anticholinergics a concern in the treatment of dementia?
They may worsen cognitive symptoms, leading to further memory impairment and confusion.
How do anticholinergics affect the cardiovascular system?
They can cause an increase in heart rate (tachycardia) by blocking acetylcholine’s action, which normally helps to slow the heart rate.
What effect do anticholinergics have on the gastrointestinal system?
Anticholinergics reduce gut motility, which can lead to constipation and other digestive issues.
How do anticholinergics affect the respiratory system?
They cause bronchodilation, which can be helpful in conditions like asthma or COPD, but may cause dry mouth and difficulty swallowing.
What effect do anticholinergics have on exocrine glands?
Anticholinergics reduce the secretion of saliva, sweat, and other bodily fluids, leading to dry mouth, difficulty swallowing, and decreased sweating.
What is the difference between anticholinergic and antimuscarinic drugs?
Anticholinergic refers to any drug that blocks acetylcholine, while antimuscarinic is a specific type of anticholinergic drug that specifically targets muscarinic receptors (a subtype of acetylcholine receptors).
Which antidepressants are commonly associated with anticholinergic properties?
Amitriptyline, Paroxetine, Doxepin, Clomipramine.
Which antihistamines can contribute to anticholinergic burden?
Diphenhydramine, Chlorphenamine, Promethazine.
