Term
what is the exact pathophys of AD?
is there a cure? |
|
Definition
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Term
| AD pahrmoctherapy focuses on improving-3 |
|
Definition
cognition
behavior
function |
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Term
|
Definition
non drug therapy
social support |
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Term
| pharmacologic therapy of AD is for- |
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Definition
| cognitive and non cognitive symtpoms |
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Term
| expectations for AD tx is _ for symtpoms and _ for behavior, funciton, adn cognitive abilites |
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Definition
short improvement
less decline |
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Term
| in AD the _ neurons are reduced |
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Definition
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Term
| in AD there is a loss of what recpotrs? |
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Definition
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Term
| *mult nueorns are destroyed in AD, but cholinergic are the most comnon |
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Definition
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Term
| ACH acts on what 2 recpotrs |
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Definition
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Term
which Muscarinic recpt is exicitory?
where is it located and what does it increase? |
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Definition
M1
post synaptic
cognitive function |
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Term
whcih muscairin recpt is inhbiitory?
wher eisit located and what does it do? |
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Definition
M2
pre synaptic
limits release of acetylcholine |
|
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Term
| whcih muscarinic recepotrd are reduced in AD? |
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Definition
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Term
nicotine agonists have _ enhacing properties?
how? |
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Definition
cognition
enhance DA and NE release |
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Term
| *nicotine nCH-R recpotrs are reduced in AD |
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Definition
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Term
| acetylcholine mimetics will ahve what kind of ADEs |
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Definition
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|
Term
| what med is shwont o imrpove short term memroy in pts |
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Definition
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|
Term
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Definition
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Term
| Xanomeline has modest effectiveness on cogntiion, but also decreases-2 |
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Definition
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|
Term
| cholinesterase inhibitors MOA |
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Definition
| enhancement of cholinergic activty |
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|
Term
| what does increasing ACH do for AD?-2 |
|
Definition
| increases nicotinic and muscarinic trnasmission |
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Term
| inhibiton of BuChE is effective for what AD stage |
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Definition
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|
Term
| *BuCHE activity correlates more with cogntive improvement than ACHE |
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Definition
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Term
| Example of cholinesterase inhibitor |
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Definition
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Term
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Definition
| reversible non selective inhibitor of cholinesterase (ACHE and BUCHE) |
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Term
|
Definition
| specific and reversible inhibitor of AChE |
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Term
| which cholinesterase inhibitor has half life of 3 days? |
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Definition
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|
Term
| cholinesterase (Exelon) MOA |
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Definition
|
|
Term
|
Definition
selective, competitive AChE inhibitior
(enhances ACH on nicotinic recpt) |
|
|
Term
| look on slide 21 for quick update on all cholinesterase inhibitors |
|
Definition
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|
Term
| ADEs of cholinesterase inhibitors-3 |
|
Definition
GI disturbances
cramping
abnormal dreams |
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|
Term
| how many pts show clear improvement on cholinesterase inhibitors |
|
Definition
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|
Term
| advantages of cholinesterase inbihots over muscarinic agoinst |
|
Definition
only increases cholinergic if endogenous activaiton
agonist= recpotrs all over brain even if not needed |
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|
Term
the diadvantage of the cholinesterase inhibitor is?
what is diff about the muscarinic agonist |
|
Definition
in late stage not as effective bc no endogenous ACH left
muscarinic will work bc postsynaptic recpotrs preserved |
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Term
| NMDA recpotrs (Glu) are important for what 2 things |
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Definition
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|
Term
| exessive Glu overstimulated NMDA leadng to? |
|
Definition
| increase intracell Ca->free radicals-> toxic |
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|
Term
| blocking NMDA recpotr will do what? |
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Definition
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|
Term
|
Definition
| blocks Glu trnasmission by antagonist of NMDA recptor |
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|
Term
| memantine (Namenda) clinical pearls-2 |
|
Definition
not metab by liver
t 1/2= 60 hrs |
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|
Term
| *you can combine the cholinesterase inhibitors and the NMDA inhibitors |
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Definition
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|
Term
|
Definition
increase blood flow
inhibits MAO
anti infective |
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|
Term
| MOa of ginkgo in AD therapy |
|
Definition
| increase M recpotrs, and increase ACH and NA |
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|
Term
| ginkgo should be takne cautiosuly for ppl on what toher meds-3 |
|
Definition
| anticoag, antiplateletm NSAIDS |
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|
Term
| do guidelines reccomedn ginkgo? |
|
Definition
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|
Term
MOA of huperzine A
its effectivness rating? |
|
Definition
reversible AChE inhibtor
not confirmed |
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|
Term
| Vitamine E has mixed evidence for use * |
|
Definition
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|
Term
| Vitamine E has what properties |
|
Definition
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|
Term
| vitamin E and selegiline in AD tx- |
|
Definition
| neither alone or combo where shown to eb effctive |
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|
Term
the progression of dementia in AD is mainly du to?
what disorders should be monitoed? |
|
Definition
brain vascular disease
HTN, high cholest, glucose |
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|
Term
| in AD there are eleavted mid lfie what? |
|
Definition
|
|
Term
| do lipid lowering agents work? |
|
Definition
| kinda- mixed trial results |
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|
Term
| women who take _ psot menopause have less chance of AD? |
|
Definition
| estrogen replacement therapy |
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|
Term
anti-inflammatory agents ahve what legnth of tx
what 2 meds arent reccomedned? |
|
Definition
long ( 2 yrs)
NSAIDS, prednisone |
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|
Term
| for non cognitive symtpoms drugs used-3 |
|
Definition
antipsychotics
anitdepressnats
anticonvulsants |
|
|
Term
| atypical and typical antipsychoitcs are used to treat 3 things in AD- |
|
Definition
| psychosis, aggressionm, agitation |
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|
Term
| _% of AD pts exhibit depresison and apathy |
|
Definition
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|
Term
| what are the most common antidepressants |
|
Definition
SSRIS
sertraline, citalopra, fluoxetine, paroxetine
axine(SNRI)
venalf |
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|
Term
| what should be avoidede with use of SSRIS |
|
Definition
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|
Term
| other agents that can be used for AD-2 (just nnot as much evidence) |
|
Definition
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|
Term
| new drug ACH co agonist MOA |
|
Definition
| sensitizes alpha nicotine recpt to make smaller Ah to activate recpotrC |
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|
Term
| which drug can reverse the memory deficits |
|
Definition
| EVP (the ACH co-agonists) |
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