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33 Cards in this Set
- Front
- Back
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Age-related CNS changes include
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DEC receptors
INC anti-ACh sensitivity Structural/physio changes similar to Alzheimers/Vascular dementia |
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THe effect(s) of increased sensitivity to anticholinergic rx related to age include
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urinary retention
constipation dry mouth blurry vision sedation cognitive dysfunction |
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Mutations in Ch 1, 14, 21 are associated with
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Early-onset familial dementia
Down's Syndrome LIMITEd INDICATIONS FOR SCREENING |
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Apolipoprotein E4 on Ch 19 is associated with
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Late-onset AD
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APOE*4 allele ____ risk and ___ onset age in dose-related fashion
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INCREASES RISK
but DECREASES age of onset |
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APOE*2 allele may have ____ effect on AD
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protective
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Things that may have a protective effect against AD include
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Intellectual stimulation
Regular physical exercise regular social interaction Mediterranean diet Fruit & veggie juice |
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RF for AD include
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Advancing age
APOE*4 Environmental exposure to Al Head injury Poor CV health Smoking |
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The 10 warning signs of AD
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Memory loss that affects job
Difficulty performing familiar tasks Problems with language Disorientation to time/place Poor or DEC judgment Problems with abstract thinking Misplacing things Changes in mood/behavior Changes in personality Loss of initiative |
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General pathophys of AD
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Tau proteins, which normally align MT down length of neuron, are defective, leading to curls and tangles of the MT
Neurons are unable to receive nutrients, so they die |
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_____ is a NT dealing with learning and memory, and is degraded via
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ACh
ACh-esterase |
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ACh-esterase Inhibitors Include
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Donepezil
Rivastigmine Galantamine |
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___ AEI has an extended release version
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Galantamine
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_____ is a mixed-type AEI and is also a reversible inhibitor of ____
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Tacrine
Butyrylcholinesterase |
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A mixed-type AEI is
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One that exhibits both noncompetitive and competitive components of inhibition
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Donepezil MOA
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A) Selective and reversible AEI
B) mixed-type AEI |
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Rivastigmine MOA
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noncompetitive slowly reversible (pseudo-irreversible) inhibitor of both ACh and Butyrylcholinesterase
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Butrylcholinesterase ...
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breaks down ACh at a rate 1/1000 that of AChEsterase, but is the main enzyme to breakdown cocaine
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ALL AEI have what as side effects?
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N/V/D
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_____ had issues with liver toxicity in addition to N/V/D
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tacrine
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Galantamine is a ___ and ___ inhibitor of ACH and also acts as a _____ to what?
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competitive
reversible positive allosteric modulator at nicotinic ACh receptors, and can potentiate the effects of nicotine |
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AEIs may improve ____ but not ____ as well as reduce
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dementia behaviors
wandering/pacing episodes of delirium |
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Atypical antipsychotic that is a partial agonist used in the tx of dementia-related psychosis
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aripiprazole
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Atypical antipyshotics are used to tx ___ and include
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dementia-related psychosis
Aripiprazole Olanzapine Quetiapine Risperidone Clozapine Ziprasidone |
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_____ is available in disintegrating tablet and long-acting injection
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Risperidone
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Memantine is indicated for use in
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Severe AD
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MOA of Memantine
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Essentially, decreases GLU-inducted neuron damage
Noncompetitive NMDA receptor antagonist Reversible, noncompetitive antagonist of 5HT3 Noncompetitive blocker at a4b2 and a7 nicotinic receptors |
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Pharmkin of memantine
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100% bioavailability after PO admin with linear profile unaffected by food, age, sex
terminal t1/2 of 60-80 hrs PPC 5-8 hrs |
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SE of memantine include
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Pain
Abnormal crying leg pain fever increased appetite LESS COMMON Vomiting Anxiety Hypertonia Cystitis Increased libido |
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AE of memantine include
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dizziness
confusion headache hallucinations tiredness |
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Curcumin is
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the yellow crap in curry that works as
anti-oxidant anti-inflammatory cholesterol-lowering reduces accumulation of amyloid in mice brains |
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Dominantly-inherited AD is associated with
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Overproduction, abnormal clearance, or increased deposition of amyloid, the plaques of which precede development of tangles and clinically expressed AD
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Immunotherapy!
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Shown to improve cognition in mouse models
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