Material
Is dementia a normal part of aging? - ANS✔✔ no
What percentage of adults develop dementia? - ANS✔✔ 15%
dysphagia - ANS✔✔ language disorder
apraxia - ANS✔✔ motor speech disorder
visual agnosia - ANS✔✔ impairment in recognizing objects
most severe Alzheimer's stage - ANS✔✔ stage 7
AD stage in which family/friends start to notice - ANS✔✔ stage 3
-donepezil hydrocholoride (Aricept) - ANS✔✔ acetylcholinesterase inhibitors:
Used to treat mild and moderate dementia
Block cholinesterase, enzyme responsible for breaking down acetylcholine
Improve or stabilize cognitive decline but do not cure or reverse
Nursing Considerations
Monitor patient for evidence of active or occult GI bleeding.
Monitor patient for bradycardia because of potential for vagotonic effects.
, Look alike-sound alike: Don't confuse Aricept with Ascriptin.
Patient Teaching
Stress that drug doesn't alter underlying degenerative disease but can temporarily stabilize or
relieve symptoms. Effectiveness depends on taking drug at regular intervals.
Tell caregiver to give drug just before patient's bedtime.
Tell patient and caregiver not to break or crush tablets.
ODTs may be taken with or without food. Have patient allow tablet to dissolve on his tongue,
then swallow with a sip of water.
Advise patient and caregiver to report immediately significant adverse effects or changes in
overall health status and to inform health care team that patient is taking drug before he
receives anesthesia.
Tell patient to avoid OTC cold or sleep remedies because of risk of increased anticholinergic
effects.
Memantine (Namenda) - ANS✔✔ Nmda receptor antagonist
Protects nerve cells against excess amounts of glutamate
To improve cognitive function in moderate to severe AD
Nursing Considerations
In elderly patients, even those with a normal creatinine level, use of this drug may impair renal
function. Estimate CrCl; reduce dosage in patients with moderate renal impairment. Don't give
drug to patients with severe renal impairment.
Monitor patient carefully for adverse reactions as he may not be able to recognize changes or
communicate effectively.
Patient Teaching
Explain that drug doesn't cure Alzheimer disease but may aid patient to maintain function for a
longer period of time.
Tell patient or caregiver to report adverse effects.