ALZHEIMERS DISEASE Flashcards
what is the Pathophysiology?
neuritic plaque
neuronal injury
neurofibrillary tangles
degeneration of neurons in cortex and limbic structure in the CNS
clinical manifestations early stage?
mild cognitive impairment
clinical manifestations mild stage?
patients become unable to work, easily confused, need supervision
clinical manifestations late stage?
patient wanders aimlessly, loss of judgement, delusions
clinical manifestations end stage?
rigid, mute, incontinent, bedridden
treatment is based on?
3 domains
- cognition
- behavioral
- functional
mini-mental state exam scores used to cat disease
class of drugs used to treat AD?
mild to moderate disease
moderate to severe
cholinesterase inhibitors
anti-glutamatergic NMDA receptor antagonist
what are the cholinesterase inhibitors?
MOA?
donepezil
rivastigmine
galantamine
centrally acting to bind cholinesterase preventing Ach degradation in the synaptic cleft used for symptom relief
name this cholinesterase inhibitor?
associated with QT prolongation except to patients with cardiac issues
donepezil
name this cholinesterase inhibitor?
transdermal patch, less exposure of it to the GI
-so less interactions than if drug were taken orally
rivastigmine
Adverse drug reactions?
GI issues
CNS issues
CV issues
peptic ulcers
chronic NSAID use
dizziness, insomnia
bradycardia
- name this anti-glutamatergic NMDA receptor antagonist?
indications: moderate to severe stages of AD
MOA: blocks glutamate (neuroexcititory NT)
mono therapy or an adjunct to the cholinesterase inhibitors
memantine
depression associated with AD is treated with?
SSRI, avoid using TCA because they are anticholinergic effects
antipsychotics to treat AD should be used when?
when symptoms are bad, when used, use low doses for low durations
Memantine ADRs?
CNS
- dizziness
- headache
- confusion
- hallucinations
GI
-constipation
