409 4 Flashcards
Most common form of dementia among persons aged 65 and older
AD
similar to Alzheimer’s disease but may progress more rapidly
Lewy body dementia
Clinical situations associated with AD include elevated
homocystein
AD: Presence of __-___ plaques
beta-amyloid
Neurotransmitter that’s decreased in AD patients
Ach
Apraxia
difficulty in motor activities
AD: MID
Multi-infarct dementia
Lewy body dementia can have signs similar to
parkinsons
Lewy body dementia: first symptom could be
visual hallucination
AD tx: Medications that retain
acetylcholine in the brain
AD medication does not
prevent the progression of the disease
AD: Exelon Patch: 2 things you should know
you need a lower dose if patient has liver disease or if patient weighs less than 100 lbs
change site of the patch daily
AD: treating free radicals
use vitamin E and selegine. This slows the rate of AD
AD: Ginko biloba
could possibly slow AD, but research is mixed
AD: Urge Incontinence
sudden urge to urinate
AD: a strategy to deal with Urge Incontinence
no fluids after dinner
MS: death usually occurs because of
infection
Relapsing-Remitting MS
there are acute attacks and No progression during remission time
Secondary-Progressive MS
it’s like “Relapsing-Remitting MS” except you also have progression
MS: High-dose _____, have not been clearly shown to improve disease outcomes
corticosteroids
The goals of (Disease Modifying Treatment) DMT
reduce inflammation and relapse rates
prolong remission
limit the onset of new lesions
How long does it take for some of the MS meds to take effect
1 to 3 months
2 common MS drugs
Glatiramer acetate
B- interferon
MS and pregnancy
- they should receive counseling if they want to become pregnant
- breast feeding can cause relapse
Parkinsons may involve only
one side of the body
Parkinson Tremor: 3 things
often the first sign, prominent at rest, and
aggravated by emotional stress
Common cause of akinesia (freezing)
Levodopa overdose
Parkinson dx is made only when
at least two of the three characteristic signs of the classic triad are present
parkinson triad
tremor, rigid, Bradykinesia
Ultimate confirmation of PD is
a positive response to anitparkinsonian drugs
2 things to know about using Neuopro
Can be used in early or late disease,
Can be add on with levodopa-carbidopa
Most common surgical tx for parkinsons is
DBS (only used when drugs don’t work)
Vision loss
MS
Bowel and bladder dysfunction
MS
GBS pain
worse at night
Pain may interfere with eating and sleeping
GBS and CSF
CSF becomes elevated after a week or so
Plasmapheresis
used for GBS to remove the plasma and take the antibodies along with it
Corticosteroids and GBS
they don’t really do anything
For mild dysphagia, patient may be able to eat in
an upright position with head flexed
For patients who experience paralytic ileus or intestinal obstruction,
parenteral feeding is required
If having feeding difficulty, the client’s weight, calorie counts, serum ____ must be evaluated at regular intervals
albumin
main goal of Antimyasthenic Medications
relieve muscle weakness
Edrophonium (Enlon) test
you inject the meds and if it improves symptoms then they have MG
MG: In cholinergic crisis, after injection of Enlon
muscle tone does not improve
Antiparkinsonian Medications (specifically Dopaminergic) : instruct client to avoid
excessive vitamin B6
Anticholinergic medications effects
Reduce tremors and drooling but have little effect on balance abnormalities, rigidity
Anticholinergic medications: instruct pt to have routine
eye exams
Anticholinergic medications: don’t mix with what other med
aspirin
Anticonvulsant Medications: instruct pt to have routine
dental check ups
Nimodipine
used in hemorrhagic stroke
The therapeutic serum drug level range for phenytoin (Dilantin) is
10 to 20
phenytoin (Dilantin) is for
seizure control
