Antihyperlipidemic & Vasodilators: Alzheimer's Disease

• Unit 6 covers Antihyperlipidemic & Vasodilators with a focus on drugs for Alzheimer's Disease.

Alzheimer's Disease

• A chronic, progressive neurodegenerative condition results in marked cognitive dysfunction.
• Onset typically occurs between the ages of 45 and 65.
• Nerves tangle and plaques form, disrupting nerve communication.
• Acetylcholine (Ach) cannot move from nerve to nerve efficiently.

Alzheimer's Disease Symptoms

• Mild stage symptoms include memory lapses, difficulty concentrating, misplacing objects, and problems with planning and organizing.
• Moderate stage symptoms include irritability, moodiness, withdrawal, frustration, anger, personality and behavior changes, confusion, and wandering.
• Severe stage symptoms include forgetting recent experiences and people known prior, requiring help with Activities of Daily Living (ADL), inability to interact, walk, sit, or swallow, and proneness to infections.

Acetylcholinesterase Inhibitors

• Donepezil is a medication in this class.
• Action: increases acetylcholine levels in neuron receptors, primarily in the brain, by inhibiting acetylcholinesterase.
• Improves cognition (attention and memory), behavior, and the ability to engage in daily activities, but does not alter the disease's progression.
• Use: FDA approved for mild, moderate, and severe Alzheimer's disease.

Donepezil Side Effects/Adverse Reactions

• Common side effects include GI upset, nausea, diarrhea, vomiting, and anorexia (with higher doses); avoid dehydration.
• Other potential side effects: headaches, dizziness, drowsiness, dry mouth, orthostatic hypotension, bradycardia, syncope, and seizures.

Donepezil Contraindications

• Hypotension and bradycardia.

Donepezil Interactions

• NSAIDs may increase GI upset.
• Other drugs causing bradycardia and hypotension should be used with caution.
• Alcohol decreases the effectiveness of the drug.

Donepezil Assessment

• Check vital signs.
• Assess the client's cognitive and physical abilities to establish a baseline dementia assessment.
• Obtain a medical/medication history.
• Assess the family's coping mechanisms.

Donepezil Nursing Interventions

• Maintain consistency in care.
• Establish realistic expectations with the family.
• Record vital signs.
• Monitor for side effects/adverse reactions.
• Minimize safety risks.
• Monitor for improvement or decline in function.
• Utilize an interprofessional team approach.

Donepezil Teaching

• Provide education on medication use.
• Medication helps with symptoms but does not cure the disease.
• Emphasize safety measures.
• Provide information on available support groups.
• Medication can be taken with or without food.
• Monitor food intake and provide foods that the client enjoys.
• Best taken at bedtime.

Donepezil Evaluation

• Assess for improvement in cognition and physical ability.

Compassionate Care Considerations

• Clients with dementia and Alzheimer's disease are at increased risk for abuse and neglect due to their increased need for care.
• Monitor clients for signs of abuse or neglect.
• Monitor family members and caregivers for caregiver role strain.
• Provide clients and families with information about resources.
• Educate clients and families about increasing physiological needs of the client.
• Conduct a nurse assessment.

This lesson covers Alzheimer's Disease, a neurodegenerative condition causing cognitive dysfunction. It discusses the symptoms in mild, moderate, and severe stages. It also addresses the role of acetylcholinesterase inhibitors like Donepezil in managing the disease.