Alzheimer’s Disease Discussion Essay
Alzheimer’s disease is a psychiatric condition that occurs due to the degeneration of brain cells over time. The condition I am mainly characterized by deterioration inability to think and changes in both the social and behavioral skills of an individual. Patients with the condition present loss of short-term memory and eventually long-term memory (Tiwari et al., 2019). Due to the various changes, the clients are unable to carry out daily activities and depend on those around them. The condition has no cure, however, patients suffering from the same are given medication to slow down the degeneration of neurons thus symptomatic management. The following paper describes a case scenario of a client suffering from Alzheimer’s disease and nursing intervention to manage his symptoms. Alzheimer’s Disease Discussion Essay
Case Description
Mr. Akkad a 76-year-old man was brought to the hospital by his eldest son with a chief complaint of “strange behavior.” Test conducted on the client indicates that the change of behavior is not due to organic changes in the brain and his CT scans are normal. The son describes the changes in behavior as gradual and has worsened with time. The most significant transition is losing interest in religious activities and others that he used to take seriously in the past. The nurse conducts a mental status exam on Mr. Akkad which he scores 18 out of 30. He is not time orientated, lacks registration and attention, and has poor calculation and recall. The diagnosis derived from the presenting symptom is a major neurocognitive disorder due to Alzheimer’s disease. Medical interventions for the client include; begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg P.O BID in 2 weeks or begin Aricept (donepezil) 5 mg orally at bedtime or begin Razadyne (galantamine) 4 mg orally BID.Alzheimer’s Disease Discussion Essay
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Evidence-Based Literature
According to Birks & Evans (2015), Exelon is commonly used in the management of Alzheimer’s disease. The mechanism of action of the drug elevates the acetylcholine levels in the brain thus enhancing nerve cells to communicate. The drug increased the flow of information between neurons despite degradation thus elevating memory loss. The therapeutic index of rivastigmine taken orally is wide thus, the nurse can begin Mr. Akkad with 1.5 mg orally BID with an increase to 3 mg BID in 2 weeks. Donepezil is a cholinesterase inhibitor that is used in the management of mild Alzheimer’s disease. The mechanism of action of the drug increases levels of available acetylcholine thus, compensation for the loss of function in cholinergic brain cells. The drug has a narrow therapeutic index thus the stat dose of 5 mg orally cannot be increased. Galantamine increases communication between nerve cells by increasing acetylcholine levels in the brain (Li et al., 2019). Therefore, the drug can also be used in the symptomatic management of Alzheimer’s disease. The drug has a wide therapeutic range; however, it is essential to start with a minimum dosage.
Expected Outcome
All three drugs increased communication between nerve cells in the brain. Therefore, the overall outcome is increased memory on Mr. Akkad. However, the drugs would have different side effects, for instance, donepezil is given at night since it causes slow and irregular heartbeats hence it may cause him to faint. Rivastigmine dosage is increased gradually to allow the nurse to assess if the client can tolerate the initial low stat dose (Rosenthal & Burchum, 2017).
Conclusion
Mr. Akkad has Alzheimer’s disease which is caused by poor neuron cell communication. The condition causes mild memory loss that can progress to severe cases where the client cannot perform daily activities without assistance. To prevent progression, such patients are given medication that increases communication between neuron cells, thus improved memory (Tiwari et al., 2019). Drugs used in treating the condition include rivastigmine, donepezil, and galantamine which have a similar mechanism of action but a different side effect. Alzheimer’s Disease Discussion Essay
References
Birks, J. S., & Evans, J. G. (2015). Rivastigmine for Alzheimer’s disease. Cochrane Database of systematic reviews, (4).
Li, D. D., Zhang, Y. H., Zhang, W., & Zhao, P. (2019). Meta-analysis of randomized controlled trials on the efficacy and safety of donepezil, galantamine, rivastigmine, and memantine for the treatment of Alzheimer’s disease. Frontiers in neuroscience, 13, 472.
Rosenthal, L., & Burchum, J. (2017). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences.
Tiwari, S., Atluri, V., Kaushik, A., Yndart, A., & Nair, M. (2019). Alzheimer’s disease: pathogenesis, diagnostics, and therapeutics. International Journal of Nanomedicine, 14, 5541.Alzheimer’s Disease Discussion Essay