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17 Cards in this Set
- Front
- Back
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What is the most common type of dementia?
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Alzheimer's
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How does age affect Alzheimer's?
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increase in age increases risk of Alzheimer's
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List risk factors for Alzheimer's:
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advanced age
family hx genetics female gender |
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Describe the pathophysiology of Alzheimer's:
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characterized by structural changes (neurofibrillary plaques/tangles), neuronal cell death, neurotransmitter deficits, and impaired neurotransmission
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List five targets for drug therapy in Alzheimer's:
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--abnormal formation of amyloid beta protein aggregates
--increased formation of excitatory NTs --free radicals --lipid oxidation --inflammatory factors |
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Define MCI:
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mild cognitive impairment:
--deficient memory, preferably corroborated by another person --essentially normal judgement, perception and reasoning --largely normal activities of daily living (DEATH) --reduced performance on memory tests, compared with other people of similar age and educational background --absence of dementia --transition phase to Alzheimer's |
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Describe symptoms of Alzheimer's:
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--memory loss
--difficulty performing familiar tasks and job skills --problems with language --disorientation to time and place --poor or decreased judgement --problems with abstract thinking --misplacing things --changes in mood or behavior --changes in personality --loss of initiative --increasing dependency on caregivers --declining function |
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Explain the two mnemonics of Alzheimer's disease:
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DEATH (dressing, eating, ambulating, toileting, hygiene)
SHAFT (shopping, housekeeping, accounting, food preparation, transportation) |
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List six classes of drugs that can be used for Alzheimer's disease:
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cholinesterase inhibitors
NMDA antagonists antioxidants statins NSAIDs estrogens |
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List some OTCs thought to be helpful in Alzheimer's:
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Vitamin E (avoid in cardiac patients due to incr death)
Vitamin C Folic Acid NSAIDs? |
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Describe acetylcholinesterase inhibitors used in Alzheimer's disease:
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donepezil (Aricept)
rivastigmine (Exelon) galantamine (Reminyl) --minimum trial of 6-8 weeks --interactions with anticholinergic medications --efficacy is questioned --usually well tolerated (rivastigmine and galantamine cause more GI sx (N/V,etc.) -first week of tx is the worse (GI), but then body adjusts |
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Describe donepezil
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(Aricept)
--slows disease progression --avoid in patients with heart block and other CV disorders --potential for interactions with drugs that undergo metabolism by CYP2D6 and CYP3A4 |
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What is unique about rivastigmine?
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available as a patch
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What is the alternative to AChEIs for treating Alzheimer's Disease?
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Namenda (memantine)
--no CYP interactions --change dose in renal impairment |
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Define delirium:
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Must have 1 and 2 and either 3 or 4
--acute onset --inattention --disorganized thinking --altered level of consciousness (symptoms not a disorder) |
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Explain the delirium mnemonic:
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Drug use
Electrolyte and physiologic abnormalities Lack of drugs Infection Reduced sensory input Intracranial problems Urinary retention and fecal impaction Myocardial problems |
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List risk factors for delirium:
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advanced age
dementia hip fracture immobility recent surgery temperature elevation pain medical illness biochemical abnormalities medications sleep deprivation sensory impairment |
