L45 Pharm tx of neurocog disorders: dementia

Question 1

3 diseases that fall under either major or mild NDCs

Answer 1

AD
Lewy Body Disease
Vascular dementia

Question 2

4 most frequent drug induced pd classes

Answer 2

• skeletal muscle relaxants
• tricyclic antidepressants
• bladder antispasmodics
• antihistaminse

Question 3

what scale is used to access cognitive functioning and is 0-30 points

Answer 3

MMSE, 30 points is the best by the way, 3-4 points a year over time for dementia pts

Question 4

better differentiates mild cognitive impairment than MMSE

Answer 4

MoCA

Question 5

options for tx in dementia (2 classes)

Answer 5

Cholinesterase inhibitors
NMDA receptor antagonist

Question 6

NMDA receptor antagonists are only FDA-approved in what level(s) of dementia

Answer 6

moderate to severe

Question 7

dosing for donepezil

Answer 7

initiate 5 mg qhs qs, increase 10 mg qhs qd after 4-6 weeks

Question 8

donepezil side effects
(6 of them)

Answer 8

• Gi bleeding
• N/V/D
• Bradycardia
• Syncope
• insomnia
• weight loss

Question 9

which of the following is a P450 and 3A3/4 substrate
A. Donepezil (Aricept)
B. Galantine (Razadyne)
C. Rivastigmine (Exelon)

Answer 9

A. Donepezil (Aricept)
B. Galantine (Razadyne)

Question 10

Galantamine (Razadyne) dosing

Answer 10

Initiate 4 mg bid for 4 weeks with breakfast and dinner

Question 11

Side effects of Galantamine
(6 of them)

Answer 11

• Gi bleeding
• weight loss
• N/V/D
• Bradycardia
• syncope
• insomnia

Question 12

doses of galantamine above 16mg/day are not recommended when

Answer 12

Renal/hepatic impairment

Question 13

Rivastigmine dosing regimen (how many times a day)

Answer 13

1.5 mg bid

Question 14

Taking rivastigmine with meals has what effect?

Answer 14

minimize GI effects

Question 15

What can lead to toxicity with rivastigmine? **

Answer 15

not removing previous patch every day (N/V/D) (SIGNIFICANT)*

Question 16

which of the following is associated with esophageal rupture?
A. Donepezil (Aricept)
B. Galantine (Razadyne)
C. Rivastigmine (Exelon)

Answer 16

C. rivastigmine (Exelon)

Question 17

side effect of aducanumab (Aduhelm)

Answer 17

ARIA (Amyloid-Related Imaging Abnormalities): up to 40% requires MRI of brain within one year of starting tx, then before 7th and 12th doses (wtf does this mean)

Question 18

Lecanemab (Leqembi) side effect

Answer 18

ARIA: Up to 30% requires MRI of brain within one year of starting tx, then before 5th, 7th, and 14th doses.

Question 19

eligibility for Aducanumab and Lecanemab

Answer 19

requires presence of amyloid beta pathology prior to initiating tx

Question 20

bolded option on the agitation interventions slide

Answer 20

introduce distraction techniques, turn attention to something pleasant