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XIO > Dementia > Flashcards

Dementia Flashcards

1
Q

dementia - % diagnosed

A

50% are never diagnosed or treated

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2
Q

dementia - reversible causes

A

D- drugs**, delirium emotions, E - endocrine
M - metabolic disturbance eye, E - ear impairments
N - nutritional disorder
T - toxicity, trauma, tumor
I - infectious cause alcohol,
A - arteriosclerosis

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3
Q

Psychiatric symptoms occur in what proportion of patients with dementia?

A

20%

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4
Q

alzheimers (achhooo with alzheimers)

A

Neuritic plaques form Neurofibrillary tangles in neurons
 Cholinergic neurotransmitter abnormality

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5
Q

Acetylcholinesterase Inhibitors for alzheimers - ex.

A

 Donepezil (Aricept®)
 Rivastigmine (Exelon®)
 Galantamine (Razadyne®)

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6
Q

Donepril (Aricept®)

A

 is the only treatment approved by the FDA for all stages of Alzheimer’s disease: mild, moderate, and severe
 is a centrally acting reversible acetylcholinesterase inhibitor
 main therapeutic use is in the palliative treatment of Alzheimer’s disease

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7
Q

when to take aricept? (Dad at night once a day)

A

once a day, with or without food, taken at bedtime. if pt as insomia, then can be taken in the am.

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8
Q

aricept - if you miss doses

A

if a patient stops taking donepezil for 7 or more days
in row, consult the provider before starting again. The patient may need to start at a lower dose to decrease the risk of side effects.

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9
Q

Donepezil (Aricept®) - how quickly does it work?

A

may take a few weeks

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10
Q

GALANTAMINE HBR (Razadyne®) (alzheimers)

A

can be used with other therapies to increase effectiveness

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11
Q

GALANTAMINE HBR (Razadyne®) - how to take? (I galantly need food twice a day)

A

with food, 2x a day. drink fluids. dose usually titrated up.

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12
Q

(NMDA)- receptor antagonist - ex (MDMA meme)

A

Memantine (Namenda®)

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13
Q

Memantine (Namenda®) (Don MUST be with mermaids)

A

titrate up, can take up to 28 days. watch renal functions. ADMINISTER with aricept.

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14
Q

Ergoloid - Alzheimers (my ego is a little off)

A

 Action: It is believed to increase blood flow to the brain. It is a combination of 3 ergot alkaloids.
 Use: Used to treat mild problems with mood, memory, concentration, or behavior in the elderly.

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15
Q

Namzaric (don and namenda)

A

combo of aricept and namenda

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16
Q

Namzaric - dosing

A

with or without food, around bedtime,

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17
Q

Acetylcholine is a

A

neurotransmitter, which is a chemical released by a nerve cell or neuron.

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18
Q

Acetylcholine - fast or slow?

A

Acetylcholine serves excitatory and inhibitory functions, which means that ACh can speed up or slow down nerve signals. In the central nervous system, its function is mainly excitatory

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19
Q

ach - the heart?

A

pacemaker rate by increasing potassium and decreasing calcium and sodium movement. As the pacemaker slows, so does your heart rate

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20
Q

When monitoring a patient who is taking a cholinergic drug, the nurse will watch for which cardiovascular effect?

A

bradycardia

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21
Q

Cholinesterase inhibitor side effects (Achhoo slows down my heart and makes my COPD worse)

A

brady, seizures, difficulty voiding, worsening COPD

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22
Q

A patient with Alzheimer’s disease accidentally took 2 weeks’ worth of a cholinergic medication. He is brought to the emergency department, is going into shock, and experiencing severe hypotension and vomiting. The nurse will expect which initial treatment?

A

Administration of atropine

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23
Q

The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer’s disease. She was diagnosed 3 months ago, has mild memory loss, and will be
receiving donepezil. What is the drug’s expected action?

A

May help to improve the symptoms of Alzheimer’s disease

24
Q

Before administering an anticholinergic for the treatment of dementia, it is most important that the nurse assess the patient for a history of (sneeze on glaucoma)

A

glaucoma

25
Q

Vascular Dementia - how fast?

A

Associated with CVA, HTN and A-Fib, abrupt onset of dementia - like 3 months

26
Q

Lewy Body (my attention is lewy today)

A

Pronounced variation in attention and alertness, second to second

27
Q

A nurse at an adult day center notes that many
patients are on (Aricept®). The function of this medication is to

A

Slow the progression of symptoms of Alzheimer’s
disease

28
Q

The nurse is assessing a patient who has been taking a cholinergic drug for 3 days. The patient has flushed skin, orthostatic blood pressure changes, and is complaining of abdominal cramps and nausea. The nurse recognizes that the patient is most likely experiencing

A

early signs of a cholinergic crisis.

29
Q

parkinson’s symptoms

A

Symptoms occur when about
dopamine stored in the substantia nigra of the basal ganglia is depleted

29
Q

parkinson’s symptoms

A

Symptoms occur when about
dopamine stored in the substantia nigra of the basal ganglia is depleted

30
Q

levodopa occur

A

“on- off phenomenon”

31
Q

meds for parkinson’s

A

 Anticholinergics
 Block cholinergic receptors
 Dopaminergics
 Convert to dopamine Dopamine agonists
Stimulate dopamine receptors
 MAO-B inhibitors
 Inhibit MAO-B enzyme that interferes with dopamine
 COMT inhibitors
Inhibit COMT enzyme that inactivates dopamine

32
Q

Anticholinergics - parkinson’s

A

Action: inhibit release of acetylcholine. Decrease tremors and rigidity

33
Q

Anticholinergics monitor for

A

increased pulse, decreased urine. increase fluid and fiber.

34
Q

Anticholinergics - side effects

A

dry mouth, use ice chips, hard candy. sunglasses for photophobia.

35
Q

Dopaminergics
◦ Carbidopa-levodopa (Sinemet®)

A

combo drug, carvadopa helps levadopa convert dopamine.

36
Q

how long does levadopa work? (Dopy works for 5 - 10 years)

A

5 - 10 years

37
Q

Amantadine (Symmetrel®) - Parkinson’s

A

Also antiviral drug for influenza A. Indirectly stimulates dopamine receptors. Taken alone or in combination with levodopa or anticholinergic

38
Q

Amantadine (Symmetrel®) - works for how long? (Amanta only works for 6 - 12 months)

A

6-12 months

39
Q

A patient with Parkinson’s disease is being treated with
carbidopa-levodopa®). The patient asks the nurse why (
Sinemet) he needs both agents. The nurse responds:

A

“The carbidopa helps the medication to reach
the brain.”

40
Q

When teaching the patient about (carbidopa-Levodopa therapy, the nurse
should include which of the following instructions? (dizzy dope)

A

Get up slowly from a sitting or lying position to avoid faintness.

41
Q

Which comment to the nurse indicates more teaching is needed for a patient taking carbidopa/levodopa? (get dope 3 times a day)

A

I know I need to take this drug once a day. (3 times a day)

42
Q

Which side effect/adverse effect of carbidopa/levodopa does the nurse realize is most important to monitor? (the dope can’t swallow)

A

dysphagia

43
Q

MAOIs

A

MAOIs break down catecholamines in the CNS, primarily in the brain

44
Q

MAOI - food interactions

A

Does not elicit the “cheese effect” of the nonselective MAOIs used to treat depression (if 10 mg or less is used)

45
Q

MAOI - use with other drugs?

A

Used in combination with levodopa or levodopa-carbidopa. Allows the dose of levodopa to be decreased
* Delays development of unresponsiveness to levodpatherapy

46
Q

Selective MAOI Therapy: Selegiline- how effective? (Selene only effective about 50% of the time)

A

on 50 - 60%.

47
Q

MAOI - dosing

A

Doses higher than 10mg/day may cause more severe adverse effects, such as hypertensive crisis

48
Q

COMT Inhibitors (Parkinsons)

A

Inhibit COMT, the enzyme responsible for the breakdown of levodopa, the dopamine precursor

49
Q

Tolcapone (Tasmar®)(Parkinsons) (Capone is our last resort bc he hurts our livers)

A

last resort - Requires monitoring of liver enzymes. Has caused severe liver failure

50
Q

Selegiline (®) is a selective MAO disease, patients must avoid tyramine-containing foods. T or F

A

if it’s 10 mg or less, we don’t need to worry about it. (swiss cheese effect)

51
Q

Antiparkinsonism
 Nursing interventions - Monitor for (meds for parks makes me dizzy)

A

Monitor for orthostatic hypotension.
◦ Administer drug with low-protein foods.
◦ Avoid vitamin B6, alcohol, other depressants.

52
Q

antiparkinsonism drugs - Nursing interventions - Monitor for (wear brown for parkinson’s)

A

◦ Do not abruptly discontinue.
◦ Warn of harmless brown discoloration of urine ands weat.
◦ Assess for suicidal tendencies.
◦ Assess symptom status and “on-off”phenomenon.
◦ Monitor blood cell counts, liver and kidney function.

53
Q

COMT

A

watch out for liver

54
Q

The nurse is teaching the patient being treated with an anticholinergic about dietary changes that might be necessary. What is the highest priority instruction for the patient?

A

D) “increase your intake of fluids while on this medication”

55
Q

dope is what color?

A

dope is brown, of course

XIO (372 decks)

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