dementia,epilepsy,parkinsons drugs

dementia

progressive decline in cognition memory and behaviour

Types of dementia

Alzheimers,lewy body,Vascular,frontotemporal

Alzheimers

Alzheimer's disease is a progressive brain disorder that primarily affects memory, thinking, and reasoning skills, leading to a gradual decline in cognitive function. It's the most common cause of dementia in older adult

lewy body

Clumps of protein forming inside brain cells a type of progressive dementia that leads to a decline in thinking, reasoning and independent function

vascular dementia

Vascular dementia is a form of dementia caused by reduced blood flow to the brain, damaging or killing brain cells

Frontotemporal

Frontotemporal dementia affects the front and sides of the brain (the frontal and temporal lobes).

Dementia is the name for problems with mental abilities caused by gradual changes and damage in the brain.

Cholinesterase inhibitors drug eg

Donepezil,Rivastigimine,Galantamine

Cholinestare inhibitors indications

GI issuses,Insomnia,bradycardia

cholinesterase affects

Cholinesterase is an enzyme that breaks down acetylcholine (ACh), a neurotransmitter essential for nerve impulse transmission

NMDA Receptor antigonist eg

memantine

NMDA Receptor antigonist side effects

hallucinations, delusions, confusion

nmda receptor antagonist effects

a process where excessive glutamate stimulation leads to neuronal damage or deathGlutamate excitotoxity

Antidepressants eg

SSRIs

Antipsychotics egs

Risperidone,Quetiapine

sleep disturbances

Melatonin,avoid benzodiazepines

antipsychotics

behavioural issues a class of medications primarily used to treat psychosis, particularly schizophrenia and other psychotic disorders

Parkinsons disease

Parkinson's disease is a progressive neurodegenerative disorder that affects movement.

Parkinsons cause

Dopamine loss in substantia nigra

Motor signs

Tremor,rigidity,bradykinesia

Non-motor signs

mood,cognition,autono,ic,dysfunction

TRAP acronym

Parkinsons medication eg

Levodopa+carbidopa

Levodopa and carbidopa

mainstay therapy

Levodopa and carbidopa side effects

dyskinesia,hypotension,hallucinations

Dopamine agonists eg

Pramipexole,Ropinirole

Pramipexole,Ropinirole job

direct stimulation

Pramipexole,Ropinirole side effects

Impulse control disorders,sleep attacks

benzodiazepines

continue to be used for a variety of conditions, including the management of neuropsychiatric symptoms associated with dementia.

MAO-B inhibitors eg

Selehiline,rasagiline

MAO-B inhibitors role

prolong dopamine

COMT Inhibitors eg

Entacapone

COMT Inhibitors role

extend levodopa effects

Anticholinegics eg

help with sympyoms in younger people

Amantadine

treat Parkinson's disease (sometimes called "paralysis agitans" or "shaking palsy")

Depression

SSRIS,SSRNIS

Psychosis

Pimavanserin,clozapine

Sleep and autonomic

tailored approaches(eg melatonin,midodrine)

3cs epilepsy

Calm, Cushion, Call

3 s’s

Stay, Safe, Side

epilepsy

recurrent unprovoked seizures

epilepsy types

focal vs generalized types

epilepsy causes

genetic ,structural, metabolic

tonic seizure

tone = muscle a tonic seizure, the tone is greatly increased: the body, arms, or legs become suddenly stiff or tense.

Clonic seizures

means fast stiffening and relaxing of a muscle that happens repeatedly. In other words, it is repeated jerking

Antiepileptic drugs

prevent seizures with minimal side effects

Monotherapy

preferred initially

Levetiracetam

Levetiracetam is a medicine used to treat epilepsy

Levetiracetam side effects

• A blocked nose or itchy throat. If it's bothering you, ask your pharmacist for something to help your symptoms. ...

• Feeling drowsy, sleepy or dizzy. ...

• Headaches. ...

• Aggression, or feeling irritable or agitated. ...

• Feeling sick or being sick (nausea or vomiting)

sodium valproate eg

gaba,Na + blocker

pregnant women should

avoid valproate

Elderly,

favour lamotrigine,levetiracetam

drug interactions

Enzyme inducers (e.g,carbamazepine)vs inhibitors

Lamotrigine

Lamotrigine is a medicine used to treat epilepsy. It can also help prevent low mood (depression) in adults with bipolar disorder.

Lamotrigine side effects

headaches

drowsy

sleepy

tremors

sleeping difficulties

Diarrhoea

Mild skin rash

challenges

side effects are they a burden or benefit

polypharmacy and drig interactions

disease progression

medication adjustments

focal seizures

Focal seizures are a type of seizure that affects only one side of your brain and body.

what to do to help

individualised therapy

monior side effects and cognitive mood

educate and involve caregivers