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24 Cards in this Set
- Front
- Back
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What is the most common cause of dementia?
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Alzheimer's disease
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Essential characteristics of Alzheimer's disease
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Memory impairment and aphasia, apraxia or agnosia, inability to think abstractly
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Pathophysiology of the disease?
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Beta-amyloid-rich senile plaques.
Neurofibrillary tangles Neuronal degeneration by ACh, glutamate & nicotine |
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How to diagnose Alzheimer's disease?
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Alzheimer’s Disease Assessment Scale-Cognitive Scale, behavioral screening, assessment of ADL’s
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Mild cognitive impairment
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Transitional stage b/w normal aging & early dementia; Consists of “memory complaint,” objective memory impairment, normal general cognitive function, intact ADL’s
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Delirium
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Acute, transient state of confusion; Consists of difficulty sustaining attention to stimuli, defective perception, disorientation & disordered sleep cycle
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Dementia
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General mental deterioration with insidious onset & gradual decline in cognition; Consists of behavioral changes (aggression, disorientation, hallucinations), impaired memory & impaired ability to perform ADL’s
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What are some characteristics of stage I of Alzheimer's.
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General forgetfulness
Short-term memory loss Can still function with ADL’s & IADL’s |
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What are some characteristics of stage II of Alzheimer's.
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Longest stage of AD
Problems with orientation to day, time Difficulty w/words, numbers, multiple commands Difficulty with IADL’s, but can still do ADL’s |
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What are some characteristics of stage III of Alzheimer's.
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Problems with cognition, memory & behavior
More aggressive, wandering off Bed-ridden or wheel-chair bound |
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Major causes of dementia?
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Drugs/medications
Emotional illness (depression) Metabolic/endocrine abnormalities (DM, thyroid, hyponatremia) Eye/ear conditions Nutritional/neurological Tumors/trauma Infections Alcoholism |
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Goals for Alzheimers?
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Improve QOL
Improve or decrease rate of memory and cognitive loss Maintain independent function Select the most efficacious treatment regimen with the greatest potential for compliance and least amount of ADE’s and drug interactions |
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Antioxidants such as Seligiline and Vitamin E are good choices for pharmacotherapy
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false they are no long recommended
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Anticholinesterase Inhibitors are the main agents used for Alzheimers?
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true
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What is the MOA of for the anticholinesterase inhibitors?
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Inhibits acetylcholinesterase
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ADEs of Donepezil (Aricept, Aricept ODT)
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N/V/D and sleep pattern changes
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ADEs of Rivastigmine (Exelon, Exelon Patch)
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N/V/D, anorexia, dizziness, drowsiness
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Drug interactions of Rivastigmine
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none have been identified
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What other MOA does Galantamine (Razadyne, Razadyne ER) have
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modulates nicotinic receptors
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What drug interactions does Galantamine have
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SSRIs, azoles, and NSAIDS
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What is the MOA of Memantine (Namenda)
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Blocks N-methyl D-aspartate
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What ADEs does Memantine (Namenda) have
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N/V/D
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Tx considerations for mild to moderate
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Cholinesterase Inhibitors to improve cognition, behavior, functioning
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Tx considerations for moderate to severe AD
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Donepezil (Aricept)
Memantine (Namenda) |
