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The Rx Consultant 

Dementia: Managing Neuropsychiatric Symptoms


This CE activity was originally published in The Rx Consultant.  If you received credit for it previously, you cannot receive credit for it again.

Although cognitive disturbances such as memory and language impairment are the most recognized symptoms of dementia, the neuropsychiatric symptoms of dementia (NPSD) are often more concerning and can cause considerable disability and caregiver distress. The total annual cost of treatment for a patient with Alzheimer's disease (AD) who is living at home is estimated at $14,500. The direct management of behavioral and psychological symptoms accounts for 30% of this total. The last drug approval by the FDA for treatment of AD occurred approximately 15 years ago. Currently, no drug is FDA approved to treat NPSD, and no drugs for this indication are on the horizon. One second generation antipsychotic, risperidone, is approved in the United Kingdom and Australia for treating aggressive/assaultive behavior due to AD that poses harm to caregivers or the patient.

Nondrug approaches to managing NPSD, while recommended, are of questionable clinical value in reducing agitation or aggression in nursing home and assisted living facility residents with dementia. A variety of drugs are prescribed (off label) every day for behavioral symptoms related to dementia, despite the lack of FDA-approval. Many distinct types of drugs have been routinely used and/or studied to treat NPSD, including acetylcholinesterase inhibitors, antiepileptics, benzodiazepines, antipsychotics, antidepressants, and most recently, a combination of dextromethorphan and quinidine. None have emerged as clearly effective, resulting in many instances where a combination of medications is prescribed.

This issue will review medications commonly prescribed for the management of dementia-associated neuropsychiatric symptoms, and discuss the pros andcons of selected agents. It is intended to serve as a guide to the safe, appropriate use of medications to manage troublesome behaviors related to AD, vascular dementia, dementia of the Lewy body type, and frontotemporal lobe dementia – the most prevalent types of dementia in the US and Europe.
Format
This CE activity is a monograph (PDF file).
 

Fee

$10.00

CE Hours

1.50

CE Units

0.150

Activity Type

  • Knowledge-based

Target Audience(s)

  • Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses

Accreditation(s)

This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.

CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours.  CE credit is automatically reported to CPE Monitor.
 
CE activities for Nurse Practitioners and Clinical Nurse Specialists: 
    This continuing education activity meets the requirements of:
        The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
        The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
 
    This is a pharmacotherapeutics/pharmacology CE activity.
  • The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
  • Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.  
  • Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
 
 
Accreditation Council for Pharmacy Education
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Requirements for CE Credit

To receive CE credit, the participant must read the monograph in its entirety, complete the online post-test and receive a score of 70% or greater, and complete the online evaluation.
 
Pharmacists and Pharmacy Technicians -
 
Be sure your profile has been updated with your NAPB e-profile # and birth date information BEFORE completing the online evaluation, or your credits cannot be reported to CPE Monitor.
 
Continuing pharmacy education credit is automatically reported to CPE Monitor once the post-test & evaluation are successfully completed.

 

 

 

Objectives

  • Describe the neuropsychiatric symptoms of dementia and the factors that may lead to problem behaviors. Discuss how the type of dementia may lead to certain behavioral symptoms and impact treatment choice.
  • Review the non-drug and drug therapy considerations for common behavioral and psychiatric symptoms of dementia. Describe the role of the combination pill containing dextromethorphan and quinidine
  • Discuss the efficacy, side effects, and dosing for the most frequently used antipsychotics and antipressants for NPSD. List drug classes that have not been proven effective and/or have more risk than benefit for the management of NPSD.

Speaker(s)/Author(s)

Chris Stock, PharmD, BCPP

R. Ron Finley, BS Pharm, RPh, CGP


Brief Bio : R. Ron Finley, BS Pharm, RPh, CGP, Clinical Pharmacist, UCSF Memory and Aging Center, San Francisco, and Consultant Pharmacist, Brain Health Center, Sutter Health, Davies Campus, San Francisco, CA.

Tracy Farnen, PharmD


Brief Bio : Tracy Farnen, PharmD; Managing Editor, The Rx Consultant.

Activity Number

0428-0000-16-007-H01-P

Release Date: Aug 20, 2016
Credit Expiration Date: Aug 20, 2019

CE Hours

1.50

Fee

$10.00