ADHD Dementia Study Guide.docx

Progressive decline o o annotated info o o goals of

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Progressive decline o o ***Annotated Info *** o o Goals of Therapy Delay progression of signs and symptoms Prolong patient independence (living at home) Preserve quality of life Ease caregiver burden o o Alzheimer’s Drugs Cholinesterase inhibitors o Donepezil (Aricept) o Rivastigmine (Exelon) o Galantamine (Razadyne, Razadyne ER) NMDA receptor antagonists o Memantine (Namenda, Namenda XR) Combination agent o Memantine extended-release and donepezil (Namzaric) capsule
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o o Cholinesterase Inhibitors Indication: mild to severe Alzheimer’s disease Dosing: titrated to improve tolerability Adverse Effects: nausea, dyspepsia, diarrhea, syncope Precautions: bradycardia, peptic ulcer disease, urinary incontinence, reversible airway disease Drug interactions : P450 3A4 and 2D6 (except Exelon patch) o o NMDA Receptor Antagonist Indication: moderate to severe Alzheimer’s disease Dosing: titrated to improve tolerability Adverse Effects: confusion, somnolence, hallucination, N&V, GI, anorexia Precautions: seizures, severe renal impairment Drug interactions: acetazolamide, HCTZ, ranitidine, sodium bicarbonate o o Behavioral Changes Associated with Dementia Agitation and Aggression Psychosis o Role of antipsychotics Disturbed Affect/Mood Withdrawn/Passive behavior Anxiety Sleep Disturbances Sun-Downing Wandering
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KEY Points 1. ADHD is a common neurobehavioral disorder in children with increasing recognition in adults 2. ADHD first-line treatment is with CNS stimulants and second-line treatment with atomoxetine (Straterra) 3. Diagnostic criteria for Alzheimer’s disease is based on the impact on cognitive domains and activities of daily living 4. Cholinesterase inhibitors may slow the progression of Alzheimer’s disease??? (from slide) 5. NMDA receptor antagonists may improve overall function??? (question marks from slide)
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  • Summer '16
  • CNS Stimulants, Attention-deficit hyperactivity disorder, Amphetamine, Methylphenidate, Atomoxetine

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