Study Guide (Alzheimer’s)

Question 1

Alzheimer’s has a-

Answer 1

Slow and insidious onset with a generally progressive and deteriorating course

Question 2

The damage of Alzheimer’s Disease is a result of-

Answer 2

Neurofibrillary Tangles and Plagues, Transmitter Defects, & Abnormal Amyloid Deposits

Question 3

What meds are used to treat Alzheimer’s?

Answer 3

Donepezil, Rivastigmine, Galantamine

Question 4

How does Donepezil, Rivastigmine, & Galantamine treat Alzheimer’s?

Answer 4

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

Question 5

In some pts, taking Donepezil, Rivastigmine, & Galantamine can-

Answer 5

Improve the ability to perform self-care + Slow cognitive deterioration of Alzheimer’s disease in mild to moderate cases

Question 6

What are the adverse effects of Donepezil, Rivastigmine, & Galantamine?

Answer 6

Bradycardia, Syncope, GI Effects, Nausea, Vomiting, & Diarrhea

Question 7

What should you make sure to monitor for a pt taking meds for treating Alzheimer’s?

Answer 7

GI Adverse Effects + Fluid Volume Deficits

Question 8

What should you make sure to promote to a pt taking meds for treating Alzheimer’s?

Answer 8

Promote Adequate Fluid Intake (The provider may titrate the dosage to reduce GI Effects)

Question 9

What should you make sure to educate to a pt taking meds for treating Alzheimer’s?

Answer 9

Teach their family to monitor HR for the pt that lives at the home

Question 10

What should you make sure to screen a pt taking meds for treating Alzheimer’s for?

Answer 10

Screen them for underlying Heart Disease

Question 11

What is Syncope?

Answer 11

Passing Out / Fainting

Question 12

Donepezil, Rivastigmine, & Galantamine are all-

Answer 12

Cholinesterase Inhibitors

Question 13

Cholinesterase Inhibitors should be used with caution in pt’s with pre-existing health conditions such as-

Answer 13

Asthma or other Obstructive Pulmonary Disorders

Question 14

Why should pt’s take Donepezil, Rivastigmine, & Galantamine with caution if they have Asthma or other Obstructive Pulmonary Disorders?

Answer 14

Bronchoconstriction can be caused by an increase of Acetylcholine

Question 15

What are the drug-drug interactions of Donepezil?

Answer 15

NSAID’s, Antihistamines, Tricyclic Antidepressants, & Conventional Antipsychotics can all reduce the therapeutic effects of Donepezil

Question 16

Don’t forget, NSAID’s increase-

Answer 16

GI Bleeding (Or bleeding in general)

Question 17

How should you administer Cholinesterase Inhibitors?

Answer 17

Start Low, Gradually Increase Dosage

Taper the Meds when Discontinued

Administer at Bedtime (With/Without Food)

Question 18

How many times can you administer Donepezil in a day?

Answer 18

Once (Because it has a long half-life time)

Question 19

How many times a day can you administer Galantamine or Rivastigmine?

Answer 19

Twice a Day

Question 20

What are the routes that you can use to administer Rivastigmine? What should you administer it with?

Answer 20

It’s PO or Patch Form (Administer with food)

Question 21

Aside from Cholinesterase Inhibitors, what other med can be used to treat Alzheimer’s Disease?

Answer 21

Memantine

Question 22

How does Memantine treat Alzheimer’s?

Answer 22

It blocks the entry of calcium into nerve cells, thus slowing down brain-cell death

Question 23

What med is approved for Severe stages of Alzheimer’s?

Answer 23

Memantine

Question 24

What are the Nursing Actions for a pt taking Memantine?

Answer 24

Can be used concurrently with Cholinesterase Inhibitors
Admin with or without food
Monitor for common reactions to the med

Question 25

What are some common reactions to Memantine?

Answer 25

Dizziness + Headache + Confusion + Constipation

Question 26

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?

Answer 26

SSRI’s (For Depression)

Antianxiety Meds (For Agitation)

Anticonvulsants (Aggression)

Antipsychotics (This is a last resort)

Question 27

Antipsychotics are typically reserved for-

Answer 27

Pt’s suffering from Hallucinations or Delusions