Alzheimer's Disease Flashcards

1
Q

What are some clinical features of dementia?

A

Episodic memory, language function, frontal executive function, apraxia, agnosia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some of the etiologies of dementia?

A

Hypothyroidism, Alzheimers disease, vitamin B12 deficiency, HIV infections, psychiatric.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Whats the main characterization of AD?

A

Amyloid plaques and neurofibrilliary tangles in corticol areas and medial temporal lobe structures. These damage the synapse and cause neuronal death.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What consequence do the neurofibrillary tangles bring?

A

Composed of excessively hyperphosphorylated tau protein and abnormal phosphorylation causes cell death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the inflammatory and the cholinergic hypotheses?

A

Amyloid plaque formation is associated with local inflammatory and immune changes.
And loss of neuronal pathways lead to many neurotransmitter abnormalities and a loss of cholinergic activity is pronounced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are other neurotransmitter abnormalities?

A

5HT, NA (loss of neurons). Increase in glutamate activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the stages of alzheimer’s disease?

A

Mild- disorientated with regard to time
Moderate - recall of recent events is severely impaired
Severe - unable to speak, incontinent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the primary goal of treatment?

A

Increase acetylcholine and reduce glutamate (NMDA-receptor activity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are drug examples?

A

Cholinesterase inhibitors - donepezil, rivastigmine, galantamine
NMDA- receptor antagonists (memantine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the differences between the agents?

A

Donepezil - selective AChE inhibitor
Rivastigmine - Inhibits both AchE and BuCHE
Galantamine - Selectively inhibits AChE and increases ACh activity of the nicotinic receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the most common adverse effects?

A

Nausea, vomiting, agitation, muscle cramps, hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are two important treatment recommendations?

A

Switch from one cholinesterase inhibitor to another if switch is due to side effect intolerability (washout period is needed) 1 week
Switch overnight if due to lack of initial benefit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some adverse effects of memantine?

A

Constipation, dizziness, confusion, headache, hypertension.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly