Medical University of Sofia, Faculty of Medicine Department of Pharmacology and Toxicology Alzheimer’s Disease Avi Gandhi (2009)

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Medical University of Sofia, Faculty of Medicine Department of Pharmacology and Toxicology Alzheimer’s Disease Avi Gandhi (2009)

Medical University of Sofia, Faculty of Medicine Department of Pharmacology and Toxicology

Background It is the progressive mental deterioration that can occur in middle or old age, due to generalized degeneration of the brain. It causes a steady loss of memory, speech, thinking, and carrying on daily activities. As a person becomes older the risk for developing Alzheimer’s increases. Annual cost can be over $50,000 Affects over 26.6 million people worldwide

Symptoms Memory loss confused about time and place changes in personality and mood trouble speaking and accomplishing tasks

7 Stages 1. No impairment 2. very mild cognitive decline 3. mild cognitive decline 4. moderate cognitive decline 5. moderately severe cognitive decline 6. severe cognitive decline 7. very severe cognitive decline

Anatomical Changes 1. Neurofibrillary tangles 2. loss of neuronal synapse 3. dead or dying nerve cells 4. formation of plaques

Treatment 1. Acetylcholine esterase inhibiters i. Rivastigmine ii. Galantamine iii. Donepezil 2. NMDA receptor antagonist i. Memantine

Side Effects nausea vomiting loss of appetite headache confusion constipation(memantin e)

1. Antidepressants i. Peroxeine ii. Fluxetine 2. Anxiolytics i. Lorazepam 3. Antipsychotic 1. Clozapine 2. Haloperidol Behavioral Drugs

Clinical Trials 1) “Alzheimer’s in Long-Term Care-- Treatment for Agitation” 2) “Cognitive Behavioral Therapy of Early Dementia” 3) “Nefiracetam in the Treatment of Alzheimer’s Disease”

Sources Harrison’s Internal Medicine Lippincott’s Illustrated Reviews Pharmacology NextBio Modern Pharmacology with Modern Clinical Applications