Neurocognitive Disorder Meds

Question 1

Who are Cholinesterase inhibitors used for? How do they help?

Answer 1

Used to improve cognitive function in clients with mild to moderate Alzheimer’s disease (AD).
- It slightly delays progression of AD

Question 2

Adverse effects of Cholinesterase Inhibitors

Answer 2

• Nausea and GI symptoms
• CNS effects - insomnia, dizziness, headache
• Bradycardia
• Syncope

Question 3

Contraindications for Cholinesterase include

Answer 3

GI bleeding
Children
Allergy to donepezil

Question 4

Interactions of Cholinesterase Inhibitors

Answer 4

Use with NSAIDs increases risk of GI bleed
Anticholinergic drugs, such as Antihistamines, decreases effect of donepezil.

Question 5

MOA for Cholinesterase Inhibitors

Answer 5

Prevent the enzyme acetylcholinesterase from inactivating acetylcholine.

Question 6

Cholinesterase inhibitors Medications

Answer 6

Donepezil (Aricept) - first line
Rivastigmine (Exelon)
Galantamine (Razadyne)
Physostigmine (Antilirium)

Question 7

What are NMDA Receptor Antagonist used for?

Answer 7

Help to treat moderate to severe Alzheimer’s disease.
- Slow the decline of cognitive and physical functioning in clients

Question 8

NMDA (medications)

Answer 8

Memantine (Namenda)

Question 9

MOA: NMDA receptor antagonist

Answer 9

Blocks excess glutamate from stimulating NMDA receptors, decreasing the influx of calcium into neurons in the brain.
Reducing the levels of calcium - restores normal nerve transmissions.

Question 10

Adverse reactions: NMDA receptor antagonist

Answer 10

CNS effects - Dizziness, headache, increased confusion
Constipation

Question 11

Contraindications: NMDA receptor antagonist

Answer 11

• Renal failure
• Use cautiously in patients with seizures, liver or renal disoders

Question 12

Interactions with other drugs: Receptor antagonist

Answer 12

• Can interact with OTC antacids (sodium bicarb) and other drugs that increase the pH of the urine
  This increase levels of memantine and lead to possible toxicity.