Meds for Alzheimers
Included In This Lesson
Study Tools For Meds for Alzheimers
Outline
Overview
- NMDA Receptor Blockers are given in early stages to affect multiple neurotransmitters to improve cognitive function
- May have some sedative effects
- Acetylcholinesterase inhibitors are given in later stages
- Increased cholinergic action (Acetylcholine)
- Important neurotransmitter for memory
- Increased cholinergic action (Acetylcholine)
- Regardless of med regimen – Alzheimer’s is a progressive disease with NO cure.
Nursing Points
General
- Common side effects of all:
- Gastrointestinal disturbances (N/V, diarrhea, etc.)
Nursing Considerations
- NMDA Receptor Blockers (Antagonists)
- Memantine (Namenda)
- Don’t give with Ketamine
- Same MOA
- Increased sedative effect
- Don’t give with sodium bicarb
- Decreases excretion → Toxicity
- Don’t give with Ketamine
- Memantine (Namenda)
- Cholinesterase Inhibitors (Parasympathomimetic)
- Donepezil (Aricept)
- Watch for bradycardia
- Galantamine (Razadyne)
- Can cause bronchoconstriction!
- Use extreme caution and discuss with Provider if patient has asthma or COPD
- Rivastigmine (Exelon)
- Caution in patients with a history of:
- Sick sinus syndrome
- PUD
- Lung issues
- Urinary obstruction
- Caution in patients with a history of:
- Donepezil (Aricept)
Transcript
Okay let’s talk about medications used for Alzheimer’s Disease or Alzheimer’s Type Dementia.
There are two main drug classes – NMDA Receptor Blockers which are usually involved in early treatment and Acetylcholinesterase Inhibitors which are used later. But what I want you to understand right away is that no matter what treatment regimen we choose, Alzheimer’s is a progressive disease with NO cure. These medications only serve to slow down progression of the disease.
So the first class of drugs used for Alzheimer’s is nmda receptor blockers. One theory of what causes Alzheimer’s is that the nmda receptor is overactive. That means that it allows excessive amounts of calcium into the cells which makes the nerve cells overworked, causing them to break down over time. By blocking that receptor we can slow the degeneration of those nerve cells. The most common example of an nmda receptor blocker is memantine or Namenda. Big nursing considerations are that you should not give it with ketamine because it has the same mechanism of action and will cause an increased sedative effect. We also don’t want to give with sodium bicarb because it can decrease excretion of the drug from the kidneys which can cause toxicity.
The second class of drugs used for Alzheimer’s is cholinesterase Inhibitors, or acetylcholinesterase inhibitors. You may remember from the neuro course that acetylcholine is an important neurotransmitter for many things in the central nervous system including memory. acetylcholinesterase is the enzyme that breaks down acetylcholine. So, by blocking the enzyme we can increase levels of acetylcholine and therefore increase cholinergic activity within the brain. Remember cholinergic activity deals with rest and digest, so everything is slowing down and constricting. So, these are the 3 most common examples and their major considerations. For Donepezil, make sure you watch for bradycardia. Galantamine can cause bronchoconstriction so make sure you’re using caution in patients with asthma. And rivastigmine should be used in caution in sick sinus syndrome, PUD, lung issues, and urinary obstruction because of the cholinergic activity.
So, let’s recap – NMDA antagonists decrease the excessive activity at the NMDA receptor to organize cognition and slow the degeneration of nerve cells. There are also acetylcholinesterase inhibitors, which can also be called parasympathomimetics that will increase acetylcholine activity to help with memory. Just remember this means increased cholinergic activity so we may see digestive upset, bradycardia, and bronchoconstriction. And remember that there is no cure for Alzheimer’s Disease – these meds just help to slow the progression of the disease.
Okay, that’s all for alzheimer’s meds. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!
Rina’s NCLEX Study Plan
Concepts Covered:
- Cardiovascular
- Emergency Care of the Cardiac Patient
- Circulatory System
- Cardiac Disorders
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of Pancreas
- Disorders of the Thyroid & Parathyroid Glands
- Hematology
- Gastrointestinal
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Multisystem
- Neurological
- Nervous System
- Central Nervous System Disorders – Brain
- Renal
- Respiratory
- Urinary System
- Respiratory System
- Noninfectious Respiratory Disorder
- Basics of NCLEX
- Test Taking Strategies
- Respiratory Disorders
- Hematologic Disorders
- EENT Disorders
- Basics of Chemistry
- Adult
- Medication Administration
- Acute & Chronic Renal Disorders
- Emergency Care of the Respiratory Patient
- Respiratory Emergencies
- Studying
- Substance Abuse Disorders
- Disorders of the Adrenal Gland
- Behavior
- Infectious Disease Disorders
- Oncology Disorders
- Female Reproductive Disorders
- Anxiety Disorders
- Renal Disorders
- Prenatal Concepts
- Vascular Disorders
- Gastrointestinal Disorders
- Peripheral Nervous System Disorders
- Integumentary Disorders
- Immunological Disorders
- Sexually Transmitted Infections
- Upper GI Disorders
- Microbiology
- Labor and Delivery
- Communication
- Proteins
- Newborn Care
- Hematologic System
- Urinary Disorders
- Eating Disorders
- Musculoskeletal Disorders
- Bipolar Disorders
- Terminology
- Pregnancy Risks
- Concepts of Population Health
- Factors Influencing Community Health
- Postpartum Complications
- Prioritization
- Psychotic Disorders
- Basics of Human Biology
- Neurologic and Cognitive Disorders
- Labor Complications
- Writing
- Statistics
- Community Health Overview
- Dosage Calculations
- Musculoskeletal Trauma
- Neurological Trauma
- Note Taking
- Cardiovascular Disorders
- Concepts of Mental Health
- Health & Stress
- Endocrine and Metabolic Disorders
- Cognitive Disorders
- Depressive Disorders
- Developmental Considerations
- Shock
- Documentation and Communication
- Legal and Ethical Issues
- EENT Disorders
- Fundamentals of Emergency Nursing
- Emotions and Motivation
- Renal and Urinary Disorders
- Digestive System
- Integumentary Disorders
- Intraoperative Nursing
- Fetal Development
- Basics of Mathematics
- Prenatal and Neonatal Growth and Development
- Childhood Growth and Development
- Preoperative Nursing
- Postoperative Nursing
- Neurological Emergencies
- Understanding Society
- Somatoform Disorders
- Reading
- Emergency Care of the Neurological Patient
- Infectious Respiratory Disorder
- Metabolism
- Oncologic Disorders
- Developmental Theories
- Basics of Sociology
- Emergency Care of the Trauma Patient
- Med Term Basic
- Med Term Whole
- Suffixes
- Central Nervous System Disorders – Spinal Cord
- Muscular System
- Neonatal
- Newborn Complications
- Male Reproductive Disorders
- Adulthood Growth and Development
- Perioperative Nursing Roles
- Concepts of Pharmacology
- Endocrine System
- Postpartum Care
- Trauma-Stress Disorders
- Psychological Disorders
- State of Consciousness
- Shock
- Skeletal System
- Learning Pharmacology
- Hematologic Disorders
- Prefixes
- Delegation
- Tissues and Glands
- Personality Disorders
- Basic
- Musculoskeletal Disorders
- Disorders of Thermoregulation
- Integumentary Important Points
- Reproductive System
- Psychological Emergencies
- Growth & Development
- Intelligence and Language
- Pediatric
- Sensory System