cognition

0.6 - 1.2

normal lithium levels to control symptoms of bipolar disorder

lithium toxicity

N/V, confusion, hyperreflexia, and nystagmus

anti-dementia medications

small benefits for slowing memory loss and remaining independent slightly longer; does not stop progression

serotonin syndrome

use of medications that lead to buildup of serotonin in the body; tremor, confusion, HTN, and tachycardia

fluoxetine and ropinirole

medications that can lead to increase serotonin

ropinirole

dopamine agonist; treat parkinson’s disease and restless leg syndrome by stimulating dopamine receptors to manage movement

donepezil

acetylcholinesterase inhibitor that blocks breakdown of acetylcholine; monitor HR for bradycardia; anti-histamines block its function; admin in evening due to sedating effect

GI bleed

complication of taking cholinergic agonist; big issue in client with gastritis; take donepezil with food to reduce risk

fluoxetine

SSRI that works to increase serotonin levels to improve symptoms of depression; do not take with alcohol; take 4-6 weeks to take effect

haloperidol

antipsychotic that can cause CNS depression, prolonged QT interval, hypotension, and extrapyramidal symptoms; monitor EKG, postural hypotension; control delirium and psychosis

rivastigmine

treat mild to moderate dementia and parkinson’s disease; given via oral or transdermal patch; improves memory, attention, and ability to perform ADLs; twice daily with food, low dose first then increase gradually

transdermal rivastigmine

rotate sites to decrease irritation; do not cut in half; avoid using heat; can cause slow or irregular HR

cholinergic toxicity

can be caused by overdose of donepezil

memantine

slow the neurodegenerative and neurotoxicity effects of Alzheimer’s disease; decrease production of RBCs; monitor RBCs, Hgb, and Hct; do not crush or chew

NMDA antagonist

memantine

pyridostigmine

another acetylcholinesterase inhibitor that can increase cholinergic effects leading to toxicity symptoms

amitriptyline, atropine, and diphenhydramine

anticholinergic medications that can block the activity of acetylcholine working against donepezil