Pharmacological Interventions Flashcards
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Read the first 7 Pharmacological Interventions flashcards as text
Lecanemab (Leqembi) and donanemab work by targeting which pathological hallmark of Alzheimer's disease?
Answer: Beta-amyloid plaques
Lecanemab and donanemab are monoclonal antibodies that target and clear beta-amyloid plaques, addressing a core pathological feature of Alzheimer's disease.
A patient on rivastigmine patch develops nausea and vomiting. In addition to supportive care, what site-rotation strategy helps minimize GI side effects from the patch?
Answer: Rotate application sites to prevent skin saturation
Rotating the patch site daily helps prevent local skin reactions and ensures consistent drug absorption, which minimizes systemic GI side effects.
Which SSRI has the most evidence supporting its use for depression in Alzheimer's disease and is generally considered first-line?
Answer: Sertraline
Sertraline is generally considered first-line for depression in Alzheimer's due to its efficacy evidence, favorable side effect profile, and low anticholinergic burden.
The TRIAD trial found that donanemab significantly slowed progression in early Alzheimer's patients with low-to-medium tau burden. This result is important because it suggests:
Answer: Earlier intervention when tau pathology is limited may yield greater benefit
Greater benefit in patients with limited tau burden suggests that treating earlier in the disease course, before tau spreads, maximizes the benefit of amyloid clearance.
A caregiver asks why their loved one needs regular blood pressure checks after starting memantine. The most accurate response is:
Answer: Memantine can cause dizziness and hypotension, increasing fall risk
Memantine can cause dizziness and hypotension, which increase fall risk in already vulnerable Alzheimer's patients, so blood pressure monitoring is prudent.
Which medication is specifically FDA-approved for the treatment of pseudobulbar affect (PBA) that may occur in some dementia patients?
Answer: Dextromethorphan/quinidine (Nuedexta)
Nuedexta (dextromethorphan/quinidine) is the only FDA-approved treatment for pseudobulbar affect, characterized by uncontrollable laughing or crying.
When prescribing any medication to an Alzheimer's patient, which principle should guide the ongoing medication review process?
Answer: Regular deprescribing reviews to minimize polypharmacy and Beers Criteria medications
Regular deprescribing reviews are essential to identify inappropriate medications (including Beers Criteria drugs) that may worsen cognition, increase fall risk, or provide minimal benefit.