DRUGS IN DEMENTIA

OUTLINE

• Definition of dementia
• Types of dementia
• Patient case and management in primary care
• Referral to secondary care
• Drugs and their mechanisms

OUTLINE

• BNF/NICE guidelines
• Summary
• Questions
• [References on separate document]

Syndrome of acquired progressive generalised cognitive impairment associated with functional decline where conscious level is normal

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• Functional impairment
• Memory impairment
• Behavioural and psychological impairment

TYPES OF DEMENTIA

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MRS MACARTHUR

HISTORY

• Gradual
• Misplacing items, forgetting names, difficulty finding words
• One specific incident
• Hasn't driven in 10 years due to rheumatoid arthritis affecting her hands.

ICE

• Insight
• Worried she is 'losing her mind'.
• Husband's mother had dementia; worried his wife has the same.
• Want to know if there is a "cure".

DEMENTIA SCREEN

REFERRAL TO MEMORY CLINIC

PHARMACOLOGY

CHOLINESTERASE INHIBITORS

MEMANTINE

NOT DISEASE MODIFYING

BNF/NICE GUIDELINES

• Assess benefit
• Discontinue when appropriate
• Reassess
• Learn carer's view of condition
• Psychotic symptom management

SUMMARY

• Dementia is common
• Rule out other cause
• Know when to refer patient
• Educate patient and carer
• Provide support

QUESTIONS?