AlzheimersFC Flashcards

1
Q

What is the most common type of dementia?

A

Alzheimer’s Disease

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2
Q

What is an indication of impairment on the Mini-Mental State Exam?

A

<24

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3
Q

What is the mainstay of therapy for AD?

A

Acetylcholinesterase inhibitors, such as donepezil

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4
Q

natural products being used to treat dementia?

A

Vitamin E, Ginko, and Huperzine A, A-phosphaticylserine, acetyl-L-carnitine

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5
Q

Main side effect you are worried about with Ginko?

A

Increases bleeding risk

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6
Q

Drug interactions with acetylcholinesterase inhibitors?

A

Anti-muscarinic agents used for overactive bladder; can decrease efficacy of the dementia drug

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7
Q

Donepezil

A

Aricept, Aricept ODT, Aricept high dose

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8
Q

Rivastigmine

A

Exelon, Exelon Patch

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9
Q

Galantamine
name
dose

A

Razadyne: 4-12 BID
Razadyne ER: 8 - 24 QD, start w/ 8 and increase every 4 wks

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10
Q

Tacrine

A

Cognex

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11
Q

Dosage forms of Aricept

A

Tablet and ODT

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12
Q

Dose of aricept for mild to moderate disease? Dose of aricept for severe disease?

A

M: 5-10 mg QHS
S: 23 mg QHS
titrated every 4wks

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13
Q

Dosage forms of Exelon

A

Tablet (BID) and Patch

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14
Q

How long should you leave on an Exelon Patch

A

24 hours

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15
Q

Side effects of Tacrine?

A

Hepatotoxicity

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16
Q

Acetylcholinesterase inhibitors with food or without?

A

Rivastigmine is with food. The others are without regards to meals

17
Q

Side effects of acetylcholinesterase inhibitors?

A

GI**, dizziness
bradycarcia w/ donepezil
GI - use ODT, donepezil at HS, use patch

18
Q

Which product should be recommended to reduce GI side effects?

A

Exelon patch or Aricept ODT

19
Q

Memantine

A

Namenda, Namenda XR

20
Q

Memantine MOA

A

Blocks NMDA, which inhibits glutamate from binding to NMDA receptors & decreases abnormal activation

21
Q

Memantine dosage forms

A

Tablet, Capsule (XR), solution

22
Q

Memantine with food or without food?

A

Take XR with food or drink, IR with or without food

23
Q

Main side effects with memantine?

A

Dizziness, GI (diarrhea) UTI, urinary retention

24
Q

Excretion of memantine?

A

Mostly excreted unchanged in the urine; do not exceed 5 mg BID if CrCl < 30 mL/min

25
Q

How often should memantine be titrated?

A

Not more than weekly

26
Q

Drugs that can worsen dementia?

A

Anticholinergics, antihistamines, antiemetics, antipsychotics, barbiturates, BZDs, skeletal muscle relaxants

27
Q

How long do you usually wait to increase dose of acetylcholinesterase inhibitors?

A

4 weeks

28
Q

How long should you wait to use the same site with the Exelon patch?

A

14 days

29
Q

Weight loss is most often associated with which acetylcholinesterase inhibitor?

A

Exelon

30
Q

What is the maximum daily dose of galantamine in patients with renal impairment?

A

16 mg/d