Final Exam: NR546 / NR 546 (Latest
Update 2024 / 2025) Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner | Questions & Answers | 100% Correct | Grade A - Chamberlain
Question:
cholinesterase inhibitors
Answer:
first line treatment increases availability of acetylcholine!may help maintain function ability and slow cognitive decline most effective in early stages of AD when postsynaptic cholinergic receptors are still available, and the neurons are not destroyed yet by the disease they do not change progression, just alleviate some symptoms NOT recommended in pregnancy and lactation.
- / 4
Question:
donepezil
Answer:
mild, moderate, severe AD also treats psychological symptoms of AD such as anxiety, depression, apathy, delusions, and pacing
MOA: inhibits centrally active acetylcholinesterase
Dose: 5 mg/day
adverse effects: GI s/s, headache, dizziness, muscle weakness
cautions: sick sinus syndrome, seizure disorder, increases gastric acid
secretion, bradycardia taper to avoid withdrawals!*donepezil at a higher dose has a higher incidence of adverse effects without increased cognitive benefit
Question:
rivastigmine
Answer:
mild-moderate AD & Parkinson’s disease dementia
MOA: inhibits both centrally active acetylcholinesterase and
butyrylcholinesterase, increasing its efficacy
dose: 1.5 mg twice daily OR transdermal patch 4.6 mg/24 hours
the transdermal patch is for dementia associated w parkinsons adverse effects: GI s/s, weakness, dizziness, tremor 2 / 4
cautions: asthma or COPD, sick sinus syndrome, GI bleeding, severe vomiting
with esophageal rupture *Medications that induce or inhibit CYP450 metabolism will not modify rivastigmine metabolism
Question:
galantamine
Answer:
mild-moderate AD
MOA: inhibits centrally active AChE, making more available. modulates
nicotinic receptors, enhance the actions of other NT by increasing the release of dopamine, norepinephrine, serotonin, GABA, glutamate
dose: 5 mg twice a day OR ER in the morning
contraindications: severe hepatic or renal impairment!
Question:
NMDA receptor antagonist
Answer:
Memantine (Namenda) only NMDA receptor antagonist approved to manage moderate to severe AD
MOA: prevents glutamate, excitatory NT, from binding at receptor site.
NMDA receptors control activity throughout the brain by regulating how much calcium enters the nerve cell and disruption info processing 3 / 4
*gold standard of treatment for cognitive symptoms is a cholinesterase inhibitor (ChEIs) and NMDA receptor antagonist
Question:
memantine side effects
Answer:
common side effects:
gastrointestinal symptoms (constipation, diarrhea, and weight gain) urinary frequency confusion dizziness headache cough
Question:
memantine precautions
Answer:
Precautions concurrent use with (amantadine, rimantadine, ketamine, or dextromethorphan) severe hepatic impairment severe renal impairment medications or conditions that increase the pH of the urine
- / 4