Geri's Flashcards
(13 cards)
Which APOE allele is associated with the highest risk of sporadic Alzheimer disease?What does it encode?
γ4 allele, a cholesterol tranport protein
Which Alzheimer’s drug can cause insomnia?
Donepezil (acetylcholinesterase inhibitor
When is Donepezil CI?
Patients with bradycardia as the drug increases vagal tone , eg: sick sinus syndrome. Also be aware of those already taking negatively chronotropic medications such as beta blockers, rate-limiting calcium channel blockers or digoxin.
What type of cognitive decline is associated with Lewy body dementia?
Progressive & fluctuant with visual hallucinations
This type of decline includes variations in cognitive function over time.
Difference between Parkinson’s and Levy Body Dementia?
In Parkinson’s disease, motor symptoms typically present at least one year before cognitive symptoms
What class of drug should be avoided in Lewy Body Dementia? Why should it be avoided?
Neuroleptics (Antipsychotics) - significant increase in mortality in dementia patients.
What is the role for cholinesterase inhibitors?
To improve some cognitive function and improvement in activities of daily living.
Which drug does NICE guidelines not support in mild dementia?
Memantine
Why should abrupt discontinuation of carbidopa-levodopa be avoided?
Reported to cause parkinsonism-hyperpyrexia syndrome, which is similar to the neuroleptic malignant syndrome
Is donepezil safe in renal failure?
Yes, it is not renally excreted
How does DAT (SPECT) scan confirm the diagnosis of Lewy Body Dementia?
DaTscan binds to dopamine transporters (DAT) in the presynaptic neurons of the striatum. In LBD, there is a significant reduction in DAT availability due to neuronal loss, which is visualised as decreased uptake on SPECT images.
What assessment tools for dementia are recommended by NICE?
In a non-specialist setting , 10-point cognitive screener (10-CS), 6-Item cognitive impairment test (6CIT) are recommended
What antipsychotic in CI in Parkinson’s?
Haloperidol
