(ALZEIMERS) Acetylcholinesterase Inhibitor UNIT 5

Question 1

Which of the following drugs are Acetylcholinesterase Inhibitors. Select all that apply

A.Rivastigmine
B. Cyclobenzaprine
C. Pyridostigmine
D. Digoxin
E. Albuterol

Answer 1

A.Rivastigmine
C. Pyridostigmine

Question 2

What is Alzheimers Disease?

Answer 2

Chronic, progressive neurodegenerative condition that causes marked cognitive dysfunction
Onset is usually between ages 45-65
Nerves tangle and plaques form
Ach is not able to move from nerve to nerve

Question 3

Alzheimers disease symptoms

Answer 3

Symptoms of mild stage
Memory lapses, difficulty concentrating, misplace objects
Planning and organizing problems
Symptoms of moderate stage
◦ Irritable, moody, withdrawn, frustration, anger
◦ Personality and behavior changes, confusion, wandering
Symptoms of severe stage
◦ Forgets recent experiences and people known prior
◦ Requires help with ADL
◦ Inability to interact, walk, sit, swallow
◦ Prone to infections

Question 4

What is the use of Rivastigmine

Answer 4

Rivastigmine (FOR BRAIN) to remember
Action
◦ Increases the amount of acetylcholine for use in the neuron receptors mainly in the brain by inhibiting
acetylcholinesterase.
◦ Increase cognitive function, slows disease process
Use
◦ Mild to moderate Alzheimer’s disease

Question 5

Side Effect of Rivastigmine

Answer 5

Rivastigmine
Side effects/Adverse reactions
◦ GI distress including anorexia that leads to weight loss and dehydration
◦ Dizziness, headache, depression, confusion, dry mouth
◦ Orthostatic hypotension

Adverse Effect
◦ Bradycardia
◦ Hypotension
◦ Seizures

Question 6

Contraindications of Rivastigmine

Answer 6

Liver and renal diseases, urinary tract obstruction, orthostatic hypotension, bradycardia, asthma, COPD, seizures, peptic ulcer disease

Contraindications
◦ Liver/renal disease
◦ Hypotension
◦ Bradycardia

Question 7

How many times should Rivastigmine be given a day ?

A. 2 times a day
B. 4 times a day
C. once a day
D. 3 times a week

Answer 7

A. 2 times a day

Rivastigmine is absorbed faster through the GI tract without food. It has a relatively short half-life and is given twice a day. The dose is gradually increased. The protein-binding power is average. It readily crosses the blood-brain barrier and is widely distributed.

Question 8

Drug Interactions of Rivastigmine

Answer 8

Interactions
◦ NSAIDS – increase GI upset
◦ Other drugs that cause bradycardia and hypotension
◦ No tobacco – decreases effectiveness of drug

Question 9

Nursing Intervention Of Rivastigmine

Answer 9

Acetylcholinesterase Inhibitors -
Rivastigmine
Nursing interventions
◦ Maintain consistency in care
◦ Record vital signs
◦ Monitor for side effects/adverse reactions. Minimize as possible
◦ Monitor for safety
◦ Monitor for improvement or decline in function

Question 10

Patient teaching of Rivastigmine

Answer 10

Teaching
◦ To medication use. Drug will help with symptoms but not cure disease
◦ To safety
◦ Available support groups
◦ May take with food. Monitor intake and make foods that patient enjoys

Question 11

Evaluation of Rivastigmine

Answer 11

Acetylcholinesterase inhibitors -
Rivastigmine
Evaluation
◦ Improvement in cognition and physical abilit