Alzheimer’s Disease

Question 1

True or False: There is a clear cause of Alzheimer’s Disease.

Answer 1

False

Can be influence by genetic and/or environmental factors

Question 2

What it is components found in the brain helps identify a patients with AD?

Answer 2

Beta-amyloid Plaques and tangles

Acumulación de placas lleva a depósitos de tau (tangles). La mayorías de estos son insolubles y se pegan a las neuronas.

Question 3

Symptoms of AD

Answer 3

-Difficulty performing familiar tasks
-Memory loss that affects job skills
-Problems using language
-Disorientation to time and place
-Loss of good judgment
-Problems with abstract thinking
-Misplacing things
-Rapid mood swings
-Personality changes
-Loss of initiative, sleeping longer than usual, and loss of interest (etapa final)

Question 4

Name the stages of AD

Answer 4

Stage 1: Normal
Stage 2: Normal aged forgetfulness
Stage 3: Mild Cognitive Impairment
Stage 4: Mild Alzheimer’s Disease (ya aquí esta diagnosticado)
Stage 5: Moderate Alzheimer’s Disease
Stage 6: Moderate severe Alzheimer’s Disease
Stage 7: Severe Alzheimer’s Disease

Question 5

Neuropathy of AD

Answer 5

The brain looses density
-Ventricle grows larger and hippocampus and cortex affected

Question 6

Beta-amyloid hypothesis

Answer 6

Their accumulation is the central event triggering neuron degeneration.

Question 7

Cholinergic Hypothesis

Answer 7

Loss of ACh in AD correlates either impairment of memory
-Atrophy of the nucleus basalis of Meynert (source of Choline Acetyltransferase) cause ACh deficit.

Question 8

How to treat AD?

Answer 8

Treatment is to inhibit AChE to slowdown ACh metabolism. However, there is no cure.

Question 9

Name the drugs that are the first line of therapy (AChE inhibitors)

Answer 9

-Donepezil
-Galantamine
-Rivastigmine
-Tacrine (discontinued)
They all improve memory and cognitive function.

Question 10

Memantine (Namenda)

Answer 10

Regulates glutamate in the brain (for Moderate to severe AD.

Question 11

Why is Donepezil more commonly used?

Answer 11

Has a long half life (70 hours)

Question 12

Rivastigmine

Answer 12

Requires multiple dose orally but as patch occurs less side effects (weight loss) and is independent of CYP enzymes.

-Inhibits AChE and Butyrylcholinesterase

Question 13

Galantamine

Answer 13

Dual mechanism
-AChE inhibitor
-also increase ACh release (activate receptors) and has a neuroprotective effect

Question 14

Why has monoclonal antibodies has not been successful to treat AD?

Answer 14

It causes brain inflammation which can continue destroying neurons and it does not show better improvement than AChE inhibitors.