Pathology and Drug Management

1. ALZHEIMER DISEASE
Presented by:- Lav Goyal
M. Pharm 1st Semester
Department of Pharmacology

2. CONTENTS
o Introduction
o Origin
o Incidence
o Stages
o Causes
o Pathophysiology
o Drugs
o Sign and symptoms
o Conclusion
o Reference

3. INTRODUCTION
• Alzheimer Disease (AD) is a progressive neurodegenerative
disorder that causes brain cells to waste away (degenerate) and die.
• Alzheimer’s Disease is the most common cause of dementia-a
continuous decline in thinking, behavioral and social skills that
disrupts a person’s ability to function independently.
• The usual onset of AD is over 65 years of age.

4. CONTD…
• AD results in progressive memory loss, impaired thinking,
disorientation , changes in personality and mood.
• There is degeneration of brain neurons especially in the
cerebral cortex and presence of neurofibrillary tangles and
plaques containing beta- amyloid cells.

5. Origin of Alzheimer’s Disease
AUGUSTE D
The disease was first described by Dr. Alois
Alzheimer , a German physician, in 1906.
Alzheimer had a patient named Auguste D, in
her fifties who suffered from what seemed to be
mental illness. But when she died in 1906, an
autopsy revealed dense deposits, now called
neuritic plaques, outside and around the nerve
cells in her brain. Inside the cells were twisted
strand of fiber, or neurofibrillary tangles. Since
Dr. Alois Alzheimer was the first person who
discovered the disease , AD was named after him.

6. INCIDENCE
In India, more than 4 million people have some form of dementia.
About 3,60,000 new cases of AD are diagnosed each year.
About 3% of men and women ages 65 to 74 have AD , and nearly half of
those age 85 and older may have the disease.

8. Causes of Alzheimer’s Disease
The cause of Alzheimer’s Disease is not known. However, several
factors are thought to be implicated in this disease.
• Acetylcholine
• Somatostatin
• Substance P
• Nor epinephrine
Neurochemical
factors
• Cigarette smoking
• Certain infections
• Metals and toxins
Environmental
factors
• Oxidized LDL receptor 1
• Angiotensin 1 converting enzyme
Genetic
factors

9. Accumulation of protein aggregates:
Intracellular: neurofibrillary tangles consisting mostly of Tau, a
microtubule-associated protein.
Extracellular: deposition of amyloid (Aβ42) plaques.
This leads to progressive cortical cell loss and cortical atrophy
PATHOLOGY

14. HISTOPATHOLOGY

15. DRUG MANAGEMNT

16. Mechanism of action
1. Acetylcholinestrase inhibitors

17. 2. NMDA antagonist

18. The “Do-It-Yourself” Approach
• Diet control
• Use of exercise
• Stress control
• Herbal remedies

19. Sign and Symptoms

20. Diagnosis
• CT scan
• MRI scan
• PET scan

21. CONCLUSION
 Cholinergic agents initially improve and transiently
maintain cognitive abilities in patients with mild to
moderate AD.
 Cognitive abilities worsen over time, indicating
treatment does not stop ( but may delay) the progression
of AD.
 New treatment that maintain cognitive ability and stop
the progression of AD are needed.

22. REFERENCE
• Goodman and Gilman’s “ The Pharmacological Basis
of Therapeutics” 12th edition
• https://www.slideshare.net/farihashikoh/alzheimers-
disease-ppt-45739925
• https://www.mayoclinic.org/diseases-
conditions/alzheimers-disease/symptoms-causes/syc-
20350447
• https://en.wikipedia.org/wiki/Alzheimer%27s_disease