Ch 22 Drugs for Alzheimer's

Question 1

AD is a relentless illness characterized by __(4)__.

Answer 1

progressive memory loss,
impaired thinking,
neuropsychiatric symptoms, and
inability to perform routine tasks of daily living

Question 2

The histopathology of AD is characterized by __(3)__ in the hippocampus and cerebral cortex

Answer 2

neuritic plaques, neurofibrillary tangles, and degeneration of cholinergic neurons

Question 3

___ are spherical, extracellular bodies that

consist of a beta-amyloid core surrounded by remnants of axons and dendrites.

Answer 3

Neuritic plaques

Question 4

In patients with AD, ___ is present in high levels

and may contribute to neuronal injury.

Answer 4

beta-amyloid

Question 5

Neurofibrillary tangles result from production of a ___, a protein that in healthy neurons serves to
maintain the orderly arrangement of neurotubules.

Answer 5

faulty form of tau

Question 6

The major known risk factor for AD is __.

Answer 6

advancing age

Question 7

AD dementia can be treated with __(2)__. Although these drugs produced statistically significant symptomatic improvement in clinical trials, benefits in most patients are marginal.

Answer 7

cholinesterase inhibitors or memantine

Question 8

___ increase the availability of acetylcholine at cholinergic synapses, and thereby enhance transmission by cholinergic neurons that have not yet been destroyed by AD.

Answer 8

Cholinesterase inhibitors (e.g., donepezil)

Question 9

Cholinesterase inhibitors produce modest improvements
in \_\_(3)\_\_ in 1 out of 12 AD patients.

Answer 9

cognition, behavior, and function

Question 10

Cholinesterase inhibitors do not __(2)__.

Answer 10

cure AD, and they do not stop disease progression.

Question 11

The efficacy of all cholinesterase inhibitors appears__..

Answer 11

equal

Question 12

By elevating acetylcholine in the periphery, all cholinesterase inhibitors can cause typical cholinergic side effects:

Answer 12

Gastrointestinal effects—nausea, vomiting, dyspepsia, diarrhea—are most common. Of greater concern, by increasing acetylcholine in the heart, these drugs can cause bradycardia, leading to fainting, falls, fall-related fractures, and pacemaker placement

Question 13

Drugs that block cholinergic receptors (e.g., first-generation antihistamines, tricyclic antidepressants, conventional antipsychotics) can reduce responses to ___.

Answer 13

cholinesterase inhibitors

Question 14

___ is the first representative of a new class of
drugs for AD, the NMDA receptor antagonists. Benefits
derive from modulating the effects of glutamate at NMDA
receptors.

Answer 14

Memantine

Question 15

Unlike cholinesterase inhibitors, all of which can be used

for mild AD, memantine is approved only for ___.

Answer 15

moderate to severe AD

Question 16

Like the cholinesterase inhibitors, memantine has only __ beneficial effects.

Answer 16

modest

Question 17

Memantine appears devoid of ___.

Answer 17

significant adverse effects

Question 18

There is no solid evidence that drugs, nutrients, supplements, exercise, cognitive training, or any other intervention can ___.

Answer 18

prevent AD or delay cognitive decline