ch 23 - neurodegenerative disorders Flashcards
new phrase to use instead of ‘dementia’
neurocognitive disorder
risk factors for parkinsons (5)
- male
- increasing age
- family h/o
- exposure to toxins
- repeated head trauma
2 symptoms that first appear in parkinsons pt
- asymmetrical resting tremor (especially arm or hand)
- unexplained falls
4 core signs parkinsons
- resting tremor (asymmetrical)
- muscular rigidity (cogwheeling)
- bradykinesia
- asymmetrical onset
meds that can help with function for pts with parkinsons
- levodopa
- carbidopa
- dopamine agonists
S+S alzheimers
- inability to remember new info
- depression
- functional decline with cognitive decline
what does the global deterioration scale assess
dementia
stage 1 = no cognitive decline
stage 7 = very severe cognitive decline
how is Dx of alzheimers made
- decline from previous level functioning
- onset was insidious
- gradual regression in cognitive abilities
- MRI and PET scan
- CSF analysis
Tx alzheimers to slow progression
- cholinesterase inhibitors: donepezil, galantamine, rivastigmine
- memantine
S+S lewy body dementia
- severe loss of thinking (problem solving, language, math)
- fluctuation in alertness and attention
- hallucinations, delusions, paranoia
- disordered sleep
- mood problems (depression, apathy, anxiety)
- autonomic S+S (falls, fainting, ortho hypoTN, incontinence, eating disorder, unexplained loss of consciousness)
core features included in Dx of lewy body dementia (4)
- fluctuating cognitive ability
- variations in attentiveness and alertness
- recurrent visual hallucinations
- parkinsonian symptoms
what can be considered a probably Dx of lewy body dementia
- dementia with 2+ core features OR
- dementia with 1 core feature and 1+ suggestive factors
what med can never be used in someone with neurocognitive disorder (lewy body dementia)
typical antipsychotics (haldol) -very high rate irreversible side effects and death
meds for lewy body dementia (2)
- cholinesterase inhibitors
- antipsychotics
difference between dementia and lewy body dementia
LBD: motor S+S develop too, and use typical antipsychotics is contraindicated
