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24 Cards in this Set
- Front
- Back
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Name the types of dementia
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Alzheimer’s
Vascular– CAD long term Dementia with Lewy bodies (Parkinson like) Frontotemporal-(most deleriums attributed to this area) |
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What are the hallmarks of dementia?
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Amyloid-beta(Aβ or Abeta)
Neurofibrillary tangles Neuronal degeneration |
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What are the signs/symptoms of dementia?
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Decline in activities of daily living
Changes in personality Increase in resource utilization e.g. Ask people to do you favors more than usual |
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Name some meds that can cause ALOC
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Antibiotics(e.g. Fluoroquinolones – causes CNS effects – altered mental status)
Antihypertensives(e.g. Propanolol – crosses the blood brain barrier (BBB)) Anti-manics(Thorazine, Olanzapine – atypical and typical anti-psychotics) Anti-parkinsonian Anti-histamines(cause sedation, anti-cholinergic like effects) H2 antagonist Narcotics Muscle relaxants(Flexeril, Cyclobenzapine) NSAIDS(can cause renal toxicity) |
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What would you look for in a CBC on a pt with ALOC
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Check if infection(Meningitis etc…)
Electrolytes(hyper/hyponatremia etc…) Glucose (hypoglycemic) BUN/SCr ratio (can tell us if we are dehydrated) If ratio is greater than 20, we can be dehydrated |
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Why are LFTs important to check in a pt with ALOC?
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Hepatic encephalopathy
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T/F Folic acid toxicity can cause dementia
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FALSE: Folic acid deficiency causes dementia
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What agents are used to Tx dementia?
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Galantamine
Memantine(Namenda) Exelon Aricept Tacrine |
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What is the MOA of Tacrine (Cognex)?
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Cholinesterase inhibitor; Elevates ACH in cerebral cortex by slowing the degradation of ACH
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What is the drug interactions of Tacrine?
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Theophyllline
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Which drug is hardly ever used anymore due to LFT problems
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Tacrine
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Which drug is used in combination with Memantine(Namenda)
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Donepezil (Aricept)
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What is the MOA of Donepezil (Aricept)
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Centrally acting cholinesterase inhibitor
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What are the drug interactions of Donepezil (Aricept)
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Dilantin
Phenobarb Rifampin All are both inducer/inhibitors |
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What are the indications of Aricept?
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mild to moderate dementia
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How is Rivastigmine (Excelon)eliminated?
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By the kidneys
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T/F If you are on Aricept you should NOT use Excelon, shouldn’t be on both
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TRUE
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Which drug stimulates the nicotinic receptors to increase ach at synapse. It may also increase serotonin and glutamate
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Galantamine (Razadyne)
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What are the drug interactions of Galantamine (Razadyne)?
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SSRI(it affects serotonin), antifungals
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What do you monitor in a pt who's on Galantamine (Razadyne?)
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Look at LFT and renal function
This drug is eliminated by kidney and liver |
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Which drug is an NMDA receptor antagonist
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Memantine (Namenda)
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T/F Namenda can be combined with cholinesterase inhibitors (e.g. Aricept)
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TRUE
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Which substance overstimulates the N-methyl-D-Asprtate NMDA receptors that can result in neuronal damage
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Glutamate
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T/F Inhibition of Nicotinic receptors impairs cognition and stimulation of nicotinic receptors may improve memory
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TRUE
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