Alzheimers

Question 1

what is the difference between mild cog and dementia

Answer 1

mild cog: measureable impairment, can still do daily tasks
dementia: sig cog impair, interferes with independence (hard to do daily tasks)

Question 2

what is the first sign of dementia

Answer 2

memory loss

Question 3

what is the pathophys behind alzheimers

Answer 3

amyloid beta plaques
tau tangles
dec Ach

Question 4

what are drug classes that can worsen dementia

Answer 4

-antipsych (arip, chlorpromazine)
-CNS depressents (benzos, opiooids, hypnotics)
-antichol (histamines, emetics, TCA)

Question 5

what are natural products that can help

Answer 5

vit E
ginkgo

Question 6

what are the different classes/meds and what stages are they used for

Answer 6

-Ach inhibitors (donepezil, rivastagine, galantamine) **ALL STAGES

-NMDA blocker (memantine) ** mod-sev

-amyloid beta antibodies (aducanumab, lecanemab) IV q 2-4 weeks **MCI or mild dementia

Question 7

what are the warnings and se for Ach inhibitors

Answer 7

-GI (N/V/D), wt loss– titrate slow (q 4-6 wks)
-cardiac (brady) and done: QT
SE: insomnia

Question 8

Donepezil (aricept) is usually given QHS, why?

Answer 8

bc of nausea
*but if pt has insomnia it can be moved to QAM

Question 9

donepezil patch (adlarity) vs rivastigmine patch (exelon)

Answer 9

Change- D: weekly, R: daily
Temp: D:fridge, R: room temp

Question 10

Memantine (namenda) caps can be on what

Answer 10

applesauce

Question 11

if a pt is stable on 10 mg of donepezil what can they switch to

Answer 11

namzaric ( memantine + donepezil)
*mem 7 mg, done 10mg