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week 8 NR 546 Exam 2024/2025 Questions With Completed & Verified Solution.
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week 8 NR 546 Exam 2024/2025 Questions With Completed & Verified Solution.
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week 8 NR 546Early (1-3 years) signs of AD - ANS short term memory deficits
disoriented to date
diminished recall of recent events
mild language and decision-making deficits
mild problem copying figures (clock drawing)
social withdrawal
mood change
personality changes
problems with managing finances
Middle (2-8 years) stage of AD - ANS disoriented to date and place
may get lost in familiar places
impaired learning new skills
agitation, aggression, restlessness, or anxiety
difficulty with ADLs such as cooking and grooming
Late (6-12 years) stage of AD - ANS disoriented to person, time, or place
non-verbal
long term memory diminished
unable to groom or dress
progress to need for total care at end stage
incontinent
motor or verbal agitation
Alzheimer's disease (AD) demographic - ANS most prevalent in people over age 65
African American (13.8%),
Hispanics (12.2%),
non-Hispanic whites (10.3%),
American Indian and Alaska Natives (9.1%),
Asian and Pacific Islanders (8.4%)
Genetics r/t AD - ANS Genes appear to play a strong role, with late-onset AD showing
heritability of 58-79% and early-onset AD showing over 90%
Neuroanatomy r/t AD - ANS amyloid plaques and neurofibrillary tangles.
atrophy of hippocampus and cerebral cortex.
Neural Networks r/t AD - ANS damage to synapses, mitochondrial abnormalities, and
inflammatory processes
, Neural Signaling r/t AD - ANS decreased acetylcholinesterase activity and a permanent loss of
cholinergic neurons
Acetylcholine (ACh) is a neurotransmitter necessary for processing memory and learning.
Diagnosis of AD - ANS comprehensive health history is key to gather clues
Rule out other causes of dementia
Early AD may include anxiety, irritability, and sleep disruption
new-onset mental health symptoms in late 50s and 60s may be in the early stage of AD
Cholinesterase Inhibitors (ChEIs)X - ANS do not change the progression of AD
provide some alleviation of symptoms
eg. donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne, Razadyne ER),
donepezil (Aricept)
Mechanism of Action - ANS inhibits centrally active acetylcholinesterase
donepezil (Aricept)
Common Side Effects - ANS gastrointestinal symptoms (nausea and diarrhea)
headache
dizziness
muscle weakness
donepezil (Aricept)
Precaution - ANS sick sinus syndrome
seizure disorder
donepezil (Aricept)
Prescribing Pearls - ANS Taper to avoid withdrawal effects.
Donepezil (Aricept) is approved to treat moderate to severe AD at 23 mg/day dose, but there is
minimal improvement in cognitive functioning when compared to a 10 mg/day dose. At the
higher dose, donepezil has a higher incidence of adverse effects.
When Donepezil (Aricept) is added to CYP2D6 or CYP3A4, there is a possibility of peripheral
side effects, and inducers of CYP2D6 and CYP3A4 may increase the rate of elimination
rivastigmine (Exelon)
Mechanism of Action - ANS acts centrally for both acetylcholinesterase and
butyrylcholinesterase, thereby potentially increasing its efficacy.
rivastigmine (Exelon)
Common Side Effects - ANS Common Side Effects
gastrointestinal symptoms (anorexia, nausea, vomiting, or diarrhea)
weakness
dizziness
tremor
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