Question

Describe the contraindications and side effects of drugs used in the treatment of Alzheimer's Disease and the drugs you can recommend against these side effects, considering the patients age and other potential comorbidities.

Answer 1

1) ans)
                Alzheimer’s disease is complex, and it is unlikely that any one drug or other intervention will successfully treat it. Current approaches focus on helping people maintain mental function, manage behavioural symptoms, and slow down the symptoms of disease.

Doctors usually start patients at low drug doses and gradually increase the dosage based on how well a patient tolerates the drug. There is some evidence that certain people may benefit from higher doses of the cholinesterase inhibitors. However, the higher the dose, the more likely side effects are to occur.

Patients should be monitored when a drug is started. All of these medicines have possible side effects, including nausea, vomiting, diarrhea, and loss of appetite. Report any unusual symptoms to the prescribing doctor right away. It is important to follow the doctor’s instructions when taking any medication, including vitamins and herbal supplements. Also, let the doctor know before adding or changing any medications

There are some medicines, such as sleep aids, anti-anxiety drugs, anticonvulsants, and antipsychotics, that a person with Alzheimer’s disease should take only:

After the doctor has explained all the risks and side effects of the medicine

After other, safer non-medication options have not helped treat the problem

You will need to watch closely for side effects from these medications.

Sleep aids are used to help people get to sleep and stay asleep. People with Alzheimer’s disease should NOT use these drugs regularly because they make the person more confused and more likely to fall. There are lifestyle changes people can make to improve their sleep. Learn more about getting a good night's sleep.

Anti-anxiety drugs are used to treat agitation. These drugs can cause sleepiness, dizziness, falls, and confusion. For this reason, doctors recommend they should only be used for short periods of time.

Anticonvulsants are drugs sometimes used to treat severe aggression. Side effects may cause sleepiness, dizziness, mood swings, and confusion.

Antipsychotics are drugs used to treat paranoia, hallucinations, agitation, and aggression. Side effects of using these drugs can be serious, including increased risk of death in some older people with dementia. They should only be given to people with Alzheimer’s disease when the doctor agrees that the symptoms are severe.

Comorbidity is the simultaneous coexistence of multiple disorders alongside a primary disorder. Common comorbid conditions are depression, anxiety, schizophrenia and addiction The prevalence of comorbid conditions in people with dementia is high.between vascular risk factors in midlife, such as hypertension, hypercholesterolemia, diabetes mellitus, smoking and being overweight, and development of Alzheimer's disease (AD) decades later, Whilst current evidence suggests that people with dementia may have poorer access to services the reasons for this are not clear. There is a need for more research looking at the ways in which having dementia impacts on clinical care for other conditions and how the process of care and different services are adapting to the needs of people with dementia and comorbidity. People with dementia should be included in the debate about the management of comorbidities in older populations and there needs to be greater consideration given to including them in studies that focus on age-related healthcare issues

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