Alzheimers/Parkinsons

Progressive neurodegenerative disease causing memory and cognitive decline

Alzheimers

Most common early symptom of alzheimers

Short term memory loss

Cause of alzheimers

Beta-amyloid plaques and tau tangles

First-line medication for mild-moderate alzheimers

Cholinesterase inhibitiors

Donezepil, rivastigmine, galantamine are examples of

Cholinesterase inhibitors

Serious cholinesterase inhibitor side effects

bradycardia

syncope

When should cholinesterase inhibitors be avoided?

Patients with symptomatic bradycardia or heart block

Donepezil patient teaching includes

take at bedtime

GI side effects usally improve

what medication Blocks NMDA receptors to reduce glutamate toxicity

Memantine

Can memantine be combined with donepezil

yes

Behavioral sx in Alzheimers

Agitation, agression, psychosis

First treatment for behavioral sx in alzheimers

Non-drug approaches

Medications sometimes used for behaviroal sx in alzheimers

SSRIs or antipsychotics

Important caregiver education for alzheimers

Provide routines

supervision

Important safety considerations in alzheimers

Fall prevention

driving assessment

home safety

Increases acetylcholine

Donepezil

Progressive loss of dopamine-producing neurons

Parkinsons

Loss of dopamine in the substantia nigra

Parkinsons

Classic parkinson sx 4

Tremor

rigidity

bradykinesia

postural instability

When is medication started with parkinson

when symptoms interfere with everyday life

Converted into dopamine in the brain

levadopa

Prevents levadopa breakdown outside of the brain

Carbidopa

Why combine carbidopa and levodopa

More dopamine reaches the brain with fewer side effects

Long term levodopa complication

dyskinesias

Symptoms return before the next dose

wearing off

Pramipexole and ropinirole are examples of

dopamine agonist

what medication class stimulate dopamine receptors

dopamine agonists

Selegiline and rasagiline are ex of

MAOB

what medication prevents dopamine breakdown

MAOB

Entacepone and opicapone are ex of

COMT medications

What medication prevents levadopa breakdown

COMT

COMT is used for

wearing-off sx

Helps dyskinesias and mild sx in parkinson

amantadine

what med treats tremors in parkinson

benzotropine

Surgical option for advanced parkinson with motor fluctuations

Deep brain stimulation

What type of meals can help reduce levodopa absorption

high protein