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Alzheimer

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Pathophysiology
Alzheimer's disease is a progressive disease that destroys memory and other important mental functions. It's the most common cause of dementia — a group of brain disorders that results in the loss of intellectual and social skills. These changes are severe enough to interfere with day-to-day life. In Alzheimer's disease, the connections between brain cells and the brain cells (ACH) themselves degenerate and die, causing a steady decline in memory and mental function. There’s no cure for Alzheimer's disease, it's important to seek supportive services and tap into your support network as early as possible.
Drugs
The drugs used are mainly indirect-acting cholinergic agonists, such as galantamine, rivastigmine, tacrine, and the prototype, donepezil. These drugs do not cure the disease but focuses on temporarily helping the patient with memory, attention, the ability to interact with others, muscle strength, and improving the ability to perform ADLs.

Prototype: donepezil (Aricept)
Indications: treatment of mild to moderate Alzheimer’s disease. Management of Alzheimer’s dementia, including severe dementia.
Mechanism of Action: Reversibly blocks acetylcholinesterase at the synaptic cleft. Causes accumulation of ACh, resulting in elevated ACh levels in the cortex, which slows the neuronal degradation of Alzheimer’s disease. Usual dose: 5-10 mg PO daily hs
Adverse effects: insomnia, fatigue, rash, nausea, vomiting, diarrhea, dyspepsia (indigestion), abdominal pain, and muscle cramps.
Drug-drug interactions: NSAIDs, which can lead to GI bleeding.
Nursing implications: * Ask patient what other medications he/she is currently taking. * Monitor therapeutic effectiveness of drugs. * Monitor for GI ulcerations. * Monitor heart activity. * Keep atropine sulfate for OD
Patient Teaching: * Report any darkening of stool, or abdominal pain. * Take more breaks between activities * Avoid extended time in warmer temperatures. * Avoid operating any heavy machinery due to the CNS effects.

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