Tuesday, March 9, 2010

Alzheimer's disease “Dementia”

Alzheimer's disease "Dementia" – Chronic


 


 

Definition  

Acquired multiple cognitive defects that include memory impairment in combination with aphasia, apraxia, agnosia or a disturbance of executive function that are severe enough to cause impairment in occupational or social functioning and that represent a decline from previous baseline functioning


 

Medical History  

* Adult, Geriatric (>65 years)

* Genetic mutation

* Down syndrome [Down syndrome - Chronic]

* Depression [Depression - Chronic]

* Head trauma

* Dietary finding

* Hypertension [Hypertension - Chronic]

* Hypercholesterolemia

* Diabetes mellitus [Diabetes mellitus - Chronic]

* Hyperhomocysteinemia

* Generalized atherosclerosis

* Smoking


 

Findings  

* Memory impairment

* Aphasia

* Apraxia

* Agnosia

* Executive dysfunction

* Depression - Chronic

* Delusions

* Hallucinations

* Agitation

* Personality change

* Aggressive behavior

* Undernourished

* Pressure sore - Chronic

* Muscle atrophy


 

Tests  


 

Evaluation of suspected dementia  

* Complete blood count

* Electrolytes measurement, serum

* Glucose measurement, serum

* Thyroid stimulating hormone measurement

* Measurement of renal function

* Hepatic function panel


 

Dementia related to vitamin B12 deficiency  

* Serum vitamin B12 measurement: Low levels of vitamin B12 may be related to the development of Alzheimer disease or dementia .


 

Suspected dementia  

* Radiography of head: CT or MRI of the head may be useful to identify abnormal pathology as a cause of dementia; however, functional neuroimaging using positron emission tomography (PET) and single photon computed emission tomography (SPECT) is not appropriate for routine examination .


 

Suspected dementia  

* Dementia test: Dementia screening tests for use in primary care populations are reasonably accurate for detecting undiagnosed dementia in patients with cognitive impairment .


 

Differential Diagnosis  

* Alzheimer's disease

* Vascular dementia

* Frontotemporal dementia

* Senile dementia of the Lewy body type

* Minimal cognitive impairment

* Depression - Chronic

* Parkinson's disease - Chronic

* HIV infection

* Huntington's disease - Chronic

* Alcohol abuse

* Traumatic brain injury

* Primary brain cancer - Acute

* Normal pressure hydrocephalus

* Vitamin deficiency

* Subacute sclerosing panencephalitis

* Jakob-Creutzfeldt disease - Chronic

* Wilson's disease - Chronic

* Neurosyphilis

* Hypothyroidism - Chronic

* Metabolic encephalopathy

* Delirium - Acute

* Schizophrenia - Chronic

* Amnestic disorder

* Factitious disorder - Acute


 


 


 

Treatment  


 

Drug Therapy  


 

Mild to moderate Alzheimer disease  


 

DONEPEZIL HYDROCHLORIDE  

Adults: Initial dose 5 mg orally daily; increase to 10 mg orally daily if tolerated


 

GALANTAMINE HYDROBROMIDE  

Adults (immediate-release): Initial dose 4 mg orally twice daily; may increase to 8 mg orally twice daily after at least 4 weeks; may increase to 12 mg orally twice daily after at least 4 weeks if previous dose tolerated; maximum dose 32 mg orally per day

Adults (extended-release): Initial dose 8 mg orally once daily; may increase to 16 mg orally once daily after a minimum of 4 weeks; may increase to 24 mg orally daily after a minimum of 4 weeks


 

RIVASTIGMINE TARTRATE  

Adults (oral dosing): Initial dose of 1.5 mg orally twice daily; may increase by 1.5 mg orally twice daily after a minimum of 2 weeks; maximum dose of 6 mg orally twice daily

Adults (transdermal dosing): Initial dose of 4.6 mg per 24 hours (5 cm2 patch) transdermally, change patch once daily; if well tolerated for a minimum of 4 weeks increase dose to 9.5 mg per 24 hours (10 cm2 patch) transdermally, change patch once daily (maximum dose 9.5 mg/24 hours)


 


 

Moderate to severe Alzheimer disease  


 

DONEPEZIL HYDROCHLORIDE  

Adults: Initial dose 5 mg orally daily; increase to 10 mg orally daily if tolerated


 

MEMANTINE HYDROCHLORIDE  

Adults: Initial dose 5 mg orally daily; may increase by 5 mg/day every week until a maximum of 10 mg twice daily is reached


 


 

Psychosis and agitation in dementia  


 

RISPERIDONE (Related toxicological information in RISPERIDONE)  

Adults: Initial dose 0.25 to 1 mg orally daily (maximum, 1.5 to 2 mg/day)


 

OLANZAPINE (Related toxicological information in OLANZAPINE)  

Adults: Initial dose 1.25 to 5 mg orally daily (maximum, 10 mg/day)


 

QUETIAPINE FUMARATE  

Adults: Initial dose 12.5 to 50 mg orally daily (maximum, 200 to 300 mg/day)


 

HALOPERIDOL

Adults: Initial dose 0.25 to 0.5 mg orally daily (maximum, 2 mg/day)


 


 

Psychotic disorder  

* Emotional and psychosocial support and education: The psychosocial and educational aspects of treatment can improve patient outcome and medication compliance and should focus on stress reduction .

1 comment:

  1. I''m Charlotte Johnson,65  years old, Here in Edmonton, Canada. With the new herbal mix medicine I purchased from Dr James herbal mix medicine West Africa  was my only way to get rid of my Alzheimer's, the herbal  mix medicine effectively reversed my condition and alleviate all symptoms.  I was initially very hesitant to discuss my Alzheimer but I just hope it can still help someone. I feel this will be very important information for all Alzheimer patients, because the most violent element in society today is ignorance. Be it any condition, a healthy diet and natural herbs and roots medicine from Dr. James is the road to fast recovery. I had suffered Alzheimer for many years, I fought for proper medical recommendation, care  and all form of humane treatment with little improvement I went through many sleepless nights and periods of intense grief, as do most families. I was recommended by a friend to use Dr. James herbal mix medicine for my Alzheimer with high hope and assurance. I never doubted my friend but to contact Dr. James. And purchased His herbal mix medicine which was effective and I finally feel my Alzheimer is gone with no more symptoms. He also told me that he cures diseases such as  Lungs diseases, kidney diseases, Warts, Bipolar disorder, Shingles,  HPV, ALS, CANCER, NEPHROTIC SYNDROME, HIV / AIDS, Herpes virus, Ovarian Cancer, Pancreatic cancers, bladder cancer, prostate cancer, Glaucoma., Cataracts, Macular degeneration, Cardiovascular disease, Autism. Enlarged prostate, Osteoporosis. Alzheimer's disease, psoriasis, Tach Diseases, Lupus, Backache, dementia, skin cancer,.testicular Cancer, Leukemia, HEPATITIS A, B, C, Contact  the great one on his email    greatcureman@gmail.com
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    ReplyDelete

SYSTEM BASED CLASSIFICATION OF DISEASES

SYSTEM BASED CLASSIFICATION OF DISEASES

Bone and Joint Diseases

  1. Gout and Hyperurecemia
  2. Osteoarthritis
  3. Rheumatoid Arthritis
  4. Acute coronary Syndroms

Cardiovascular Diseases

  1. Arrhymias
  2. Cardiopulmanary Resuscitation
  3. Heart Failure
  4. Hypertension
  5. Hyperlipidemia
  6. Ischemic Heart Diseases
  7. Shock
  8. Stroke
  9. Venous Thromboembolism

Dermatrologic Diseases

  1. Acne
  2. Psoriasis
  3. Skin Disorders and Cutaneous Drug Eruptions

Endocrine Diseases

  1. Cirrhosis
  2. Portal Hypertension

Gastrointestinal Diseases

  1. Irritable Bowel Syndrome
  2. Constipation
  3. Diarrhea
  4. Gastroesophagal Reflux Disease
  5. Hepatitis, Viral
    1. Hepatitis A
    2. Hepatitis B
    3. Hepatitis C
  6. Nausea and Vomiting
  7. Pancreatitis
  8. Peptic Ulcer disease

Gynecologic and Obstetric Diseases

  1. Contraception
  2. Hormone therapy

Hematologic Diseases

  1. Anemia
    1. Megaloblastic Anemia

i. Megaloblastic Anemia due to Folate Deficiency

ii. Megaloblastic Anemia due to Vitamine B12 Deficiency

    1. Sickle Cell anemia
    2. Hemolytic Anemia
    3. Iron Deficiency Anemia
    4. Aplastic Anemia
    5. Iron Deficiency Anemia

Infectious Diseases

  1. Central Nervous System infections
  2. Endocarditis
  3. Fungal infections, Invasive
  4. Gastrointestinal Infection
  5. HIV / AIDS
  6. Intra-Abdominal Infection
  7. Respiratory Tract infections, Lower
  8. Respiratory Tract infections, Upper
  9. Sepsis and Septic Shock
  10. Sexually transmited Diseases (STD)
  11. Skin and soft tissue infection
  12. Tuberculosis
  13. Urinary tract infection and prostatitis

Neurologic Diseases

  1. Epilepsy
  2. Headache
    1. Migraine
    2. Cluster Headache
  3. Pain management
  4. Parkinson’s Diseases
  5. Status epilepticus

Nutritional Diseases

  1. Enteral Nutrition
  2. Obesity
  3. Parentaral Nutrition

Onchologic Diseases

  1. Breast cancer
  2. Colorectal Cancer
  3. Lung cancer
  4. Lymphomas
  5. Prostate cancer
  6. Cervical Cancer
  7. Esophageal Cancer
  8. Gastric Cancer
  9. Head and Neck Cancer
  10. Lung Cancer
  11. Ovarian Cancer
  12. Pancreatic Cancer
  13. Primary bone Cancer
  14. Primary Brain cancer
  15. Testicular Cancer
  16. Thyroid Gland Cancer
  17. Urinar Bladder cancer
  18. Uterine Cancer

Ophtalmic Diseases

  1. Glaucoma

Psychiatric Diseases

  1. Alzhimer’s Diseases
  2. Anxiety Disease
  3. Bipolar Diseases
  4. Depressive diseases
  5. Schizophrenia
  6. Sleep Diseases
  7. Substance-Related Diseases

Renal Diseases

  1. Acid base Diseases
  2. Acute renal Failure
  3. Chronic Renal Failure
  4. Drug Dosing in renal insufficiency
  5. Electrolyte Homeostasis

Respiratory Diseases

  1. Allergic Rhinitis
  2. Asthma
  3. Chronic Obstructive Pulmonary Diseases

Urologic Diseases

  1. Benign Prostatic, Hyperplasia
  2. Erectile Dysfunction
  3. Urinary Incontinence