Study Guide (Alzheimer’s) Flashcards
Alzheimer’s has a-
Slow and insidious onset with a generally progressive and deteriorating course
The damage of Alzheimer’s Disease is a result of-
Neurofibrillary Tangles and Plagues, Transmitter Defects, & Abnormal Amyloid Deposits
What meds are used to treat Alzheimer’s?
Donepezil, Rivastigmine, Galantamine
How does Donepezil, Rivastigmine, & Galantamine treat Alzheimer’s?
They increase Acetylcholine at the Cholinergic Synapse by inhibiting its breakdown via Acetylcholinesterase, which increases the availability of Acetylcholine at Neurotransmitter Receptor Sites in the CNS
In some pts, taking Donepezil, Rivastigmine, & Galantamine can-
Improve the ability to perform self-care + Slow cognitive deterioration of Alzheimer’s disease in mild to moderate cases
What are the adverse effects of Donepezil, Rivastigmine, & Galantamine?
Bradycardia, Syncope, GI Effects, Nausea, Vomiting, & Diarrhea
What should you make sure to monitor for a pt taking meds for treating Alzheimer’s?
GI Adverse Effects + Fluid Volume Deficits
What should you make sure to promote to a pt taking meds for treating Alzheimer’s?
Promote Adequate Fluid Intake (The provider may titrate the dosage to reduce GI Effects)
What should you make sure to educate to a pt taking meds for treating Alzheimer’s?
Teach their family to monitor HR for the pt that lives at the home
What should you make sure to screen a pt taking meds for treating Alzheimer’s for?
Screen them for underlying Heart Disease
What is Syncope?
Passing Out / Fainting
Donepezil, Rivastigmine, & Galantamine are all-
Cholinesterase Inhibitors
Cholinesterase Inhibitors should be used with caution in pt’s with pre-existing health conditions such as-
Asthma or other Obstructive Pulmonary Disorders
Why should pt’s take Donepezil, Rivastigmine, & Galantamine with caution if they have Asthma or other Obstructive Pulmonary Disorders?
Bronchoconstriction can be caused by an increase of Acetylcholine
What are the drug-drug interactions of Donepezil?
NSAID’s, Antihistamines, Tricyclic Antidepressants, & Conventional Antipsychotics can all reduce the therapeutic effects of Donepezil
Don’t forget, NSAID’s increase-
GI Bleeding (Or bleeding in general)
How should you administer Cholinesterase Inhibitors?
Start Low, Gradually Increase Dosage
Taper the Meds when Discontinued
Administer at Bedtime (With/Without Food)
How many times can you administer Donepezil in a day?
Once (Because it has a long half-life time)
How many times a day can you administer Galantamine or Rivastigmine?
Twice a Day
What are the routes that you can use to administer Rivastigmine? What should you administer it with?
It’s PO or Patch Form (Administer with food)
Aside from Cholinesterase Inhibitors, what other med can be used to treat Alzheimer’s Disease?
Memantine
How does Memantine treat Alzheimer’s?
It blocks the entry of calcium into nerve cells, thus slowing down brain-cell death
What med is approved for Severe stages of Alzheimer’s?
Memantine
What are the Nursing Actions for a pt taking Memantine?
Can be used concurrently with Cholinesterase Inhibitors
Admin with or without food
Monitor for common reactions to the med
What are some common reactions to Memantine?
Dizziness + Headache + Confusion + Constipation
Aside from Memantine and Cholinesterase Inhibitors, what other meds may be used to treat Alzheimer’s?
What specific things are these meds used to treat about Alzheimer’s?
SSRI’s (For Depression)
Antianxiety Meds (For Agitation)
Anticonvulsants (Aggression)
Antipsychotics (This is a last resort)
Antipsychotics are typically reserved for-
Pt’s suffering from Hallucinations or Delusions
