NR 601 Final Wk 7/8 Dementia, Delirium, AD, grief, palliative,
hospice questions with verified answers
· Lewy Body/Parkinson's Dementia
In addition to dopamine, Acetylcholine is depleted, Ans✓✓✓ causing disruption
of perception, thinking, and behavior
· Lewy Body/Parkinson's Dementia
Lewy bodies deplete Ans✓✓✓ dopamine
· Lewy Body/Parkinson's Dementia
o Resultant parkinsonian symptoms includew Ans✓✓✓ stiff, shuffling gait,
stiffness in arms and legs, tremors, frequent falls, masklike facies with blank stare,
flat affect, stooped posture, drooling, runny nose
· Lewy Body/Parkinson's Dementia
This is characterized by the Diffuse presence of Ans✓✓✓ Lewy body proteins in
brain, including cerebral cortex
· Mixed Dementia
o More than Ans✓✓✓ one type of dementia (e.g., combination of AD and
vascular dementia)
AD Staging
In moderate, the disease spreads to what lobe of the brain Ans✓✓✓ lateral lobe.
AD Staging
,In severe, the disease spreads to what lobe of the brain Ans✓✓✓ occipital lobe.
AD Staging
mild disease starts in what lobe of the brain Ans✓✓✓ medial temporal lobe and
progressive to the lateral temporal lobe and parietal lobe.
AD Staging guidelines (Kennedy p.444)
AD Mild- moderate Ans✓✓✓ Obvious memory impairment
Overt instrumental ADL impairment
Basic ADLs failing
Prominent behavioral difficulties
Shortened attention span Language difficulty Variable social skills Supervision
required
2-10 years
AD Staging guidelines (Kennedy p.444)
AD Severe Ans✓✓✓ Memory fragments only
No recognition of familiar people
Assistance with basic ADLs required
Fewer troublesome behaviors
Reduced mobility
Weight loss, infections Seizures, dysphagia Incontinence Groaning, moaning,
grunting
1-2 years or longer
,AD Staging guidelines (Kennedy p.444)
Preclinical AD includes what features Ans✓✓✓ Impaired memory, excused or
covered Insidious instrumental ADLs losses (money handling, bills) Preserved
basic ADLs Poor judgment and decisions Subtle personality changes
Decreased spontaneity, sense of initiative Increased anxiety, socially normal
2-4 years or longer
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
DONEPEZIL (ARICEPT) Ans✓✓✓ FDA approval 1996; mild, moderate, severe AD
Benefit: Typically well tolerated; improves cognitive and behavioral status,
caregiver burden, and capacity for ADLs
Dosage strengths (mg) 5, 10
Starting dose 5 mg qd
Maximum recommended dose 10 mg qd
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
Galantamine (RAZADYNE) Ans✓✓✓ FDA approval 2001; mild, moderate AD
Benefit Signifi cantly improves cognitive, behavioral, and functional symptoms of
AD
Dosage strengths (mg) 4, 8, 12 Extended Release: 8, 16, 24
Starting dose 4 mg bid
Maximum recommended dose 8-10 mg bid Extended Release: 16-24 mg qd
AD Treatment
, FDA-Approved Medications for Alzheimer ' s Disease
MEMANTINE (NAMENDA) (NMDA RECEPTOR AGONIST Ans✓✓✓ FDA approval
2004; moderate, severe AD
Benefit: Delays loss of daily functions, cognition, and global performance;
decreases agitation
Dosage strengths (mg) Titrate to 10 mg bid over 4 wks
Maximum recommended dose 10 mg bid
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
Rivastigmine (EXCELON) Ans✓✓✓ FDA approval 2000; mild, moderate AD
Benefit: Improves cognitive, behavioral, and functional impairments; is more
selective for central processes and regions critical for cognition and memory
Dosage strengths (mg) 1.5, 3, 4.5, 6
Starting dose 1.5 mg bid
Maximum recommended dose 6 mg bid
AD Treatment from lecture
Patients with AD can be referred to what? to prevention complications including
confusion, falls, UTIs, fractures. Ans✓✓✓ memory care
AD Treatment from lecture
You will treat mild to moderate patients with Ans✓✓✓ DONEPEZIL (ARICEPT) &
Rivastigmine (EXCELON) & Galantamine (RAZADYNE)
AD Treatment from lecture
hospice questions with verified answers
· Lewy Body/Parkinson's Dementia
In addition to dopamine, Acetylcholine is depleted, Ans✓✓✓ causing disruption
of perception, thinking, and behavior
· Lewy Body/Parkinson's Dementia
Lewy bodies deplete Ans✓✓✓ dopamine
· Lewy Body/Parkinson's Dementia
o Resultant parkinsonian symptoms includew Ans✓✓✓ stiff, shuffling gait,
stiffness in arms and legs, tremors, frequent falls, masklike facies with blank stare,
flat affect, stooped posture, drooling, runny nose
· Lewy Body/Parkinson's Dementia
This is characterized by the Diffuse presence of Ans✓✓✓ Lewy body proteins in
brain, including cerebral cortex
· Mixed Dementia
o More than Ans✓✓✓ one type of dementia (e.g., combination of AD and
vascular dementia)
AD Staging
In moderate, the disease spreads to what lobe of the brain Ans✓✓✓ lateral lobe.
AD Staging
,In severe, the disease spreads to what lobe of the brain Ans✓✓✓ occipital lobe.
AD Staging
mild disease starts in what lobe of the brain Ans✓✓✓ medial temporal lobe and
progressive to the lateral temporal lobe and parietal lobe.
AD Staging guidelines (Kennedy p.444)
AD Mild- moderate Ans✓✓✓ Obvious memory impairment
Overt instrumental ADL impairment
Basic ADLs failing
Prominent behavioral difficulties
Shortened attention span Language difficulty Variable social skills Supervision
required
2-10 years
AD Staging guidelines (Kennedy p.444)
AD Severe Ans✓✓✓ Memory fragments only
No recognition of familiar people
Assistance with basic ADLs required
Fewer troublesome behaviors
Reduced mobility
Weight loss, infections Seizures, dysphagia Incontinence Groaning, moaning,
grunting
1-2 years or longer
,AD Staging guidelines (Kennedy p.444)
Preclinical AD includes what features Ans✓✓✓ Impaired memory, excused or
covered Insidious instrumental ADLs losses (money handling, bills) Preserved
basic ADLs Poor judgment and decisions Subtle personality changes
Decreased spontaneity, sense of initiative Increased anxiety, socially normal
2-4 years or longer
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
DONEPEZIL (ARICEPT) Ans✓✓✓ FDA approval 1996; mild, moderate, severe AD
Benefit: Typically well tolerated; improves cognitive and behavioral status,
caregiver burden, and capacity for ADLs
Dosage strengths (mg) 5, 10
Starting dose 5 mg qd
Maximum recommended dose 10 mg qd
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
Galantamine (RAZADYNE) Ans✓✓✓ FDA approval 2001; mild, moderate AD
Benefit Signifi cantly improves cognitive, behavioral, and functional symptoms of
AD
Dosage strengths (mg) 4, 8, 12 Extended Release: 8, 16, 24
Starting dose 4 mg bid
Maximum recommended dose 8-10 mg bid Extended Release: 16-24 mg qd
AD Treatment
, FDA-Approved Medications for Alzheimer ' s Disease
MEMANTINE (NAMENDA) (NMDA RECEPTOR AGONIST Ans✓✓✓ FDA approval
2004; moderate, severe AD
Benefit: Delays loss of daily functions, cognition, and global performance;
decreases agitation
Dosage strengths (mg) Titrate to 10 mg bid over 4 wks
Maximum recommended dose 10 mg bid
AD Treatment
FDA-Approved Medications for Alzheimer ' s Disease
Rivastigmine (EXCELON) Ans✓✓✓ FDA approval 2000; mild, moderate AD
Benefit: Improves cognitive, behavioral, and functional impairments; is more
selective for central processes and regions critical for cognition and memory
Dosage strengths (mg) 1.5, 3, 4.5, 6
Starting dose 1.5 mg bid
Maximum recommended dose 6 mg bid
AD Treatment from lecture
Patients with AD can be referred to what? to prevention complications including
confusion, falls, UTIs, fractures. Ans✓✓✓ memory care
AD Treatment from lecture
You will treat mild to moderate patients with Ans✓✓✓ DONEPEZIL (ARICEPT) &
Rivastigmine (EXCELON) & Galantamine (RAZADYNE)
AD Treatment from lecture
