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PHM 704: gremlins and wizards > Witches and Wizards: Agitation in Dementia > Flashcards

Witches and Wizards: Agitation in Dementia Flashcards

1
Q

anx

A

rangews from worry and being nervus to fear and being scaed

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2
Q

apathy

A

laack of interest or emotion

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3
Q

agitiation

A

observable, nonspecific, restless behaviros that are excessive, inapprorpaite, adn repitive

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4
Q

aggression

A

involves physiclaly or verbally threatening behaiors direted at people, obejcts, or self

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5
Q

halluiations

A

perceptions (e.g. visual, auditory, tactile, olfactory, gustaory) w/o stimuli

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6
Q

delusons

A

fixed, idoisycratic or false perceptions or beliefs with little if any bass in reality and are not the result of religous or cultural norms

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7
Q

disinhibition

A

loss of inhibition, a lack of restraint, disregard for social convention, impulsiness, poor safety awareness, an inability to stop strong responses, desires, or emotions

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8
Q

treatment of NPS in dementia

A
  • prescribing of psych meds last try all posible non-pharm (and even deprescribing) first
    • symptom guided prescribing
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9
Q

mild NPS s/s

A
  • depression
  • anx
  • irritblity
  • apathy
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10
Q

severe NPS s/s

A
  • agitaiton
  • aggression
  • vocalizations
  • hallucinations
  • delusions
  • disinihbition
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11
Q

causes of NPS in dementia pts

A
  • meds
  • infection
  • CVA
  • trauma
  • pain
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12
Q

environmental intervention for NPS tretent: educatio of family and caregivers

A
  • scheduled toileting (pts don’t respond to urge to pee)
  • offer graded assistance (as little help as possible)
  • role modeling
  • cueing
  • positive reinforment
  • avoid adversaral debates, redirect conversation isntead
  • maintain calm demeaner
  • caregiver support groups (alzheimer’s assocaition)
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13
Q

environmental intervention for NPS tretent: structruing phsycial and psychosocial environment

A
  • music
  • walking/light exercise
  • simulate family presece with video or audio tapes
  • pet therapy
  • speak at pt comprehesion level
  • white noise
  • bright light
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14
Q

treatemnt of apathy

A
  • methylphenidate
  • dextroamphetamine
  • modafanil
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15
Q

mood stabilizers in dementia with manic-like featurews

A
  • CBZ
  • lamotrigine
  • Li
  • VPA - preferred dt sprinkle cap (ease of admin) and better tolerability
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16
Q

treatment of sundowning

A
  • ACUTE: trazadone first, then quetiapine
    • do NOT use queitapine for insomnia, use it for sundowning which has behavioral aspects
  • LONG TERM: trazadone or melatonin, quetiapine if those don’t work
17
Q

treatment of insomnia in dementia

A
  • sleep hygeine
  • acute: trazodone, melatonin, mirtazapine; short term BZD if htose fail
  • long term: trazodone, melatoin
18
Q

treatment of agitiaton in dementia

A

brexpiprazole (given scheduled, not prn)

BBW of death still exists

19
Q

treatment of agitiaton in context of psychosis in dementia

A

second gen antipsychotics

aripiprazole, olanzapine, quetiapine, risperidone

20
Q

treatment of agitiaton in context of depression in dementia

A

SSRI

21
Q

brexpipirzole ADR

A
  • HA
  • dizziness
  • UTI
  • nasopharyngitis
  • sleep disturbances
22
Q

the risks of antipsychotics in dementia pts are highest when?

A

early on in treatment

23
Q

which antipsychotics are safer in demenita pts

A
  • quetiapine
  • brexiprazole (im assuming here)
24
Q

____% of alz pts have psychotic symptoms

A

20%, most alz pts are ‘pleasantly confused’

psychotic symptos include delusions and hallucinations

25
Q

parkinson’s hallucination treatment vs lewy body dementia hallucinatoin treatment

A
  • parkinson’s: quetiapine
  • lewy body: no APS

  • parkinson’s doesn’t have cognitive deline
  • lewy body dementia: cogitive delcine accompanied by motor features of parkinson’s
26
Q

____% of alz pts have symptoms of agitaion or aggression

A

up to 80%

27
Q

treatment of anx, mild to moderate irritabilty

A
  • trazadone
  • buspar - doesnt work as welel in pts who have been on benzos
28
Q

treatment of agitiaton or aggressi ounresponsive to first line treatment

A
  • VPA
  • CBZ
  • olanzapiine IM
29
Q

treatment of sexual agression, impulse control in men

A
  • second gen antipsychotic or VPA
  • if no response estrogen OR medroxyprogesterone IM
30
Q

insomnia vs sundowning

A

sundowning is incomnia with: pacing, wandering, yelling, combativeness

other s/s include:
- forgetful
- confused
- delirious
- agitated
- anx
- restless

PHM 704: gremlins and wizards (16 decks)

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