alzheimers

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signs of dementia

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memory loss; difficulty plannings/organizing; getting lost in familiar places; repeating words/info; difficulty finding words for common objects; inability to learn new information; apathy or socail disengagement; delusions and agitation; poor coordination and motor function

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dementia types

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alzheimers, vascular, lewy body

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22 Terms

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signs of dementia

memory loss; difficulty plannings/organizing; getting lost in familiar places; repeating words/info; difficulty finding words for common objects; inability to learn new information; apathy or socail disengagement; delusions and agitation; poor coordination and motor function

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dementia types

alzheimers, vascular, lewy body

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most common form of dementia

alzheimers

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alzheimers basic patho

amyloid beta plaques, tau tangles; death of cholinergic neurons, resulting in decrease acetylcholine

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diagnostic assessment tools

MMSE, MoCA, DSM-5, ADCS-ADL

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MMSE

folstein mini mnetal state exam; max score fo 30, <24 indicated memory disorder

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MoCA

Montreal cognitive assessment

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ADCS-ADL

alzheimers disase cooperative study- activities of daily living; functional assessment

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Reversible causes of memory impairment

vitamin b12 or d deficicnecy; depression; infection

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Medications that worsen dementia

antispsychotics (aripiprazole, chlorpromazine), CNS depressants (barbiturates, BZDs, opioids, hyponotics, muscle relaxants), drugs with antihcholinergic effects (antiemetics, antihistamines, central or peripheral anticholienrgics, TCAs)

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what additional tests might be done to confirm alzheimers

CSF and blood tests for elevated amyloid beta and tau concentrations

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Non-drug treatment (prevention)

control BG, BP, and cholesterol, physical activity, healthy diet and congitive rehabilitation

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natural product treatment

Vitamine E, actetyl-l-carnitine, ginkgo biloba, vinpocetine

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Vitamin E roll in treatment

2000 iu dialy; minimally slows rate of decline for patients with mild to moderate dementia

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Drug class that is primary treatment for all stages

acetylcholinesterase inbhitors

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Additional agent for moderate to severe disease

memantine

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Amyloid beta directed antibodies

aducanumab and lecanemab

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FDA approved antipsychotic for dementia associated agitation

brexipiparazole/rexulti

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Other antipsychotics sometimes used off label for dementia associated agitation

olanzapine, quetiapine

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Acetylcholinesterase inhbitor drug list

donepezile, rivastigmine, galantamine

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Memantine moa

NMDA receptor blocker; prevents glutamate from binding to NMDA receptor and causing overstimulation/neuronal death

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Acetylcholinesterase inhibitor DI

Causeiotn with drugs that lower HR (beta blockers, diltiazem/verapamile, digoxin), drugs that have anticholinergic effects, may increase gastric acid secretion (caution with hx of GI bleeding)