Your SlideShare is downloading. ×
0
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Cognitive enhancers and_more2
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Cognitive enhancers and_more2

836

Published on

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
836
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
165
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • What are anticholingeric effects?– Drowsiness, constipation, blurred vision, urinary hesitance, and dry mouth. Orthostatic hypertension also. SSRI – selecttive Serotonin reuptake inhibitors
  • Transcript

    • 1. Pharmacotherapy for Older Adults With Dementia University of Miami School of Nursing and Health Studies
    • 2. Cholinesterase Inhibitors <ul><li>Aricept (Donepezil) </li></ul><ul><li>Exelon (Rivastigmine) </li></ul><ul><ul><li>Increases cholinergic synaptic transmission by inhibiting acetylcholinesterase in the synaptic cleft </li></ul></ul><ul><ul><li>Leads to increased concentrations of acetylcholine in the brain, and the increased concentrations are believed to be responsible for improvement in symptoms </li></ul></ul>
    • 3. Anti-inflammatory Agents <ul><li>NSAIDS-Aspirin-Glucocorticoids </li></ul><ul><ul><li>Epidemiological data to protect against the development of Alzheimer ’s </li></ul></ul><ul><ul><li>Patients with rheumatoid arthritis suggest theoretical protection </li></ul></ul><ul><ul><li>Theory is cytokines, small secreted proteins , which mediate and regulate inflammation </li></ul></ul>
    • 4. Free Radical Reduction with Antioxidants <ul><li>Vitamin C and E </li></ul><ul><ul><li>limit free-radical formation, oxidative stress and lipid perioxidation </li></ul></ul>
    • 5. Gingko Biloba <ul><li>Treatment of mild cerebral insufficiency </li></ul><ul><ul><li>powerful antioxidant and contributes to the oxidation of free radicals which are believed to contribute to premature aging and dementia </li></ul></ul><ul><ul><li>Used for mild cognitive impairment </li></ul></ul>
    • 6. Cholesterol Lowering Drugs <ul><li>Known to lower risk for cardiovascular disease </li></ul><ul><li>Under investigation for lowering risk of Alzheimer ’s Disease </li></ul>
    • 7. Recommended Antipsychotics <ul><li>Atypical (D1-D2) </li></ul><ul><ul><li>Risperidone (Risperdal) </li></ul></ul><ul><ul><ul><li>Least sedating of the atypicals </li></ul></ul></ul><ul><ul><ul><li>Used in lower dosages </li></ul></ul></ul><ul><ul><ul><li>Fewer extrapyramidal effects, orthostatic hypotension, sedation, or tardive dyskinesia </li></ul></ul></ul><ul><ul><li>Quetiapine (Seroquel) </li></ul></ul><ul><ul><ul><li>Used for psychotic symptoms with those who have Parkinson ’s disease </li></ul></ul></ul>
    • 8. Antipsychotics to Avoid <ul><li>Conventional: Haloperidol (Haldol) </li></ul><ul><ul><li>has adverse effects: </li></ul></ul><ul><ul><ul><li>EPS and TD </li></ul></ul></ul><ul><ul><ul><li>Anticholinergic effects </li></ul></ul></ul><ul><ul><ul><li>Sedation and potential for falls </li></ul></ul></ul><ul><li>Atypical: Olanzapine (Zyprexa) </li></ul><ul><ul><li>has threefold increase in risk of cerebrovascular accidents (CVAs) in aged patients with dementia. </li></ul></ul>
    • 9. Anticonvulsants Used for Mood Stabilization <ul><li>Agitation or psychosis or both occur in half or more of patients with dementia at some point during illness </li></ul><ul><ul><li>Divalproex sodium (Depakote) and carbamazepine (Tegretol) are effective and generally well tolerated by aged. </li></ul></ul><ul><ul><li>Recommend: Depakote has fewer adverse effects and drug-drug interactions </li></ul></ul><ul><ul><ul><li>Dose: 125 mg bid with titration up 125 mg per dose weekly </li></ul></ul></ul>
    • 10. Sedatives <ul><li>Zolpidem (Ambien) </li></ul><ul><li>Zaleplon (Sonata) </li></ul><ul><li>Trazodone (Desyrel) </li></ul><ul><ul><li>Marked calming action </li></ul></ul><ul><ul><li>Orthostatic effect </li></ul></ul>
    • 11. Drugs for Depression in Dementia

    ×