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2024 NR 546 WEEK 8 EXAM WITH CORRECT ANSWERS
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2024 NR 546 WEEK 8 EXAM WITH CORRECT ANSWERS
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2024 NR 546 WEEK 8 EXAM WITHCORRECT ANSWERS
Neuroanatomy r/t AD - CORRECT-ANSWERSamyloid plaques and
neurofibrillary tangles.
atrophy of hippocampus and cerebral cortex.
Neural Networks r/t AD - CORRECT-ANSWERSdamage to synapses,
mitochondrial abnormalities, and inflammatory processes
Neural Signaling r/t AD - CORRECT-ANSWERSdecreased acetylcholinesterase
activity and a permanent loss of cholinergic neurons
Acetylcholine (ACh) is a neurotransmitter necessary for processing memory
and learning.
Diagnosis of AD - CORRECT-ANSWERScomprehensive 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 - CORRECT-ANSWERSdo 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 - CORRECT-ANSWERSinhibits centrally active
acetylcholinesterase
donepezil (Aricept)
Common Side Effects - CORRECT-ANSWERSgastrointestinal symptoms
(nausea and diarrhea)
headache
dizziness
muscle weakness
donepezil (Aricept)
Precaution - CORRECT-ANSWERSsick sinus syndrome
, seizure disorder
donepezil (Aricept)
Prescribing Pearls - CORRECT-ANSWERSTaper 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 - CORRECT-ANSWERSacts centrally for both
acetylcholinesterase and butyrylcholinesterase, thereby potentially
increasing its efficacy.
rivastigmine (Exelon)
Common Side Effects - CORRECT-ANSWERSCommon Side Effects
gastrointestinal symptoms (anorexia, nausea, vomiting, or diarrhea)
weakness
dizziness
tremor
rivastigmine (Exelon)
Precautions - CORRECT-ANSWERSPrecautions
asthma or COPD
sick sinus syndrome
GI Bleeding
weight < 50 kg
Prescribing Pearls
Rivastigmine (Exelon) - CORRECT-ANSWERSPrescribing Pearls
Rivastigmine (Exelon) is administered orally or topically (transdermal patch).
The transdermal patch is used for dementia associated with Parkinson's
disease.
Medications that induce or inhibit CYP450 metabolism will not modify
rivastigmine (Exelon) metabolism
galantamine (Razadyne, Razadyne ER)
Mechanism of Action - CORRECT-ANSWERSMechanism of Action
Galantamine (Razadyne, Razadyne ER) acts by elevating acetylcholine (Ach)
in the cerebral cortex, modulating the nicotinic Ach receptors to increase Ach
release from existing presynaptic nerve terminals. It also increases
glutamate and serotonin levels; however, the benefits of this action are
unknown
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