Alzheimer's Disease

Question 1

What test helps diagnose Alzheimer’s?

What do anticholinergics do in Alzheimer’s?

What natural products help Alzheimers?

Answer 1

MMSE <24

Centrally-acting anticholinergics should be avoided, Oxybutynin, diphenhydramine, benztropine, active cognitive impairment.

Vitamin E, Ginkgo biloba, Ginkgo increases bleeding risk however.

Question 2

What are key drugs that can worse Alzheimer’s?

How do the acetylcholinesterase inhibitors work and what is their name?

What are the aci’s side effects?

Answer 2

Antihistamines and antiemetics, Antipsychotics, Barbiturates, Benzodiazepines, Central anticholinergics, Peripheral anticholinergics, Skeletal muscle relaxants, Other CNS depressants.

Inhibit centrally active acetylcholinesterase. Donepezil (Aricept).

Bradycardia, Insomnia, Nausea, Donepezil is dosed QHS to help lower nausea, Exelon patch and donepezil ODT have less GI side effects, rotate sites, If stable on donepezil 10 mg, can switch to Namzaric. Caution with other drugs that can lower HR. Drugs that can lower efficacy are anticholinergic effects.

Question 3

What is Memantines MOA and it’s name and side effects?

Where to put exelon patch?

Answer 3

Blocks NMDA receptors. Namenda. Do not crush or chew Namzaric or ER capsule, sprinkled on applesauce.

Same time each day, upper or lower back, upper arm or chest, rotate application site.