Alzheimer's Dz

Question 1

what drugs can induce delirium

Answer 1

benzos
anticholinergis
antihistamines
anticonvulsants
beta blockers
sympathomimetics
lithium
diuretics

Question 2

sudden alterations in cognitive function

impaired attention span

Answer 2

Delirium

Question 3

what underlying etiology can cause dementia

Answer 3

UTI
MI
pneumonia
pain

Question 4

Neurodegenerative disease characterized by non-reversible, progressive cognitive deterioration, together with declining activities of daily living and by neuropsychiatric symptoms or behavioral changes

Answer 4

Alzheimer’s Disease

Question 5

what score on the MMSE is mild-moderate

Answer 5

10-26

Question 6

what score on the MMSE is moderate to severe

Answer 6

3-14

Question 7

what are 2 antioxidants that can help delay AD progression

Answer 7

Vitamin E (every AD patient should be on this) 
Selegiline (works similarly to Vit E)

Question 8

may be a potential treatment for AD, only recommended to be used in women who need it for HRT.

Answer 8

Estrogen

Question 9

drugs to use for Mild AD

Answer 9

cholinesterase inhibitiors

Question 10

drugs to use for moderate to severe AD

Answer 10

memantine +/- cholinesterase inhibitior

donepezil

Question 11

ADR w/ tacrine causing it to no longer be used?

Answer 11

Hepatotoxicity

Question 12

cholinesterase inhibitiors examples

Answer 12

donepezil
galantamine
rivastigmine

Question 13

DOC for cholinesterase inhibitiors It is selective for ACHE and a reversible inhibitor

Answer 13

donepezil

Question 14

how is donepezil partially eliminated

Answer 14

kidneys

Question 15

Pseudo-irreversible non-competitive inhibitior of AchE. Not metabolized via P450. Also available in a patch or syrup

Answer 15

Rivastigmine

Question 16

AchE that also stimulates nicotoinic receptor sites. Metabolized via P450. Avoid in patient w/ kidney or liver impairment

Answer 16

Galantamine

Question 17

cholinergic stimulation ADRs

Answer 17

N/V
Diarrhea
Anorexia
Dizziness
Dyspepsia
Agitation

Question 18

conditions to use caution w/ for cholinesterase inhibitiors

Answer 18

bradycardia
ulcers (increased gastric acid secretion)
COPD / asthma- bronchoconstriction

Question 19

during anesthesia if on a cholinesterase inhibitors what can occur?

Answer 19

exaggerated succinylcholine neuromuscular blockade

Question 20

what is the main NMDA receptor agonist

Answer 20

Memantine

Question 21

indication for memantine

Answer 21

moderate to severe AD (MMSE 3-14)

Question 22

is there any evidence of prevention or slowed neurodegeneration in AD w/ Memantine?

Answer 22

No

Question 23

when must you adjust the does w/ Memantine?

Answer 23

renal impariment

Question 24

cautions to use w/ Memantine

Answer 24

drugs that are also NMDA antagonists (amantadine, ketamine, edextromethorphan)

Question 25

expected ADRs w/ memantine

Answer 25

``` agitation insomnia diarrhea urinary incontinence UTI ```

Question 26

what is BPSD?

Answer 26

Behavior and Psychological Symptoms of Dementia

Question 27

How to tx BPSD

Answer 27

nonpharm, but may include antipsychotic and/or antidepressants