Pharmacologic Profile

General Use

Management of Alzheimer's dementia.

General Action and Information

All agents act by ↑ the amount of acetylcholine in the CNS by inhibiting cholinesterase. No agents to date can slow the progression of Alzheimer's dementia. Current agents may temporarily improve cognitive function and therefore improve quality of life.

Contraindications

Hypersensitivity.

Precautions

Use cautiously in patients with a history of "sick sinus syndrome" or other supraventricular cardiac conduction abnormalities (may cause bradycardia). Cholinergic effects may result in adverse GI effects (nausea, vomiting, diarrhea, weight loss) and may also ↑ gastric acid secretion resulting in GI bleeding, especially during concurrent NSAID therapy. Other cholinergic effects may include urinary tract obstruction, seizures, or bronchospasm.

Interactions

Additive effects with other drugs having cholinergic properties. May exaggerate the effects of succinylcholine-type muscle relaxation during anesthesia. May ↓ therapeutic effects of anticholinergics.

Nursing Implications

Assessment

• Assess cognitive function (memory, attention, reasoning, language, ability to perform simple tasks) throughout therapy.
• Monitor nausea, vomiting, anorexia, and weight loss. Notify health care professional if these side effects occur.

Potential Nursing Diagnoses

• Disturbed thought process (Indications)
• Imbalanced nutrition: less than body requirements
• Deficient knowledge related to disease processes and medication regimen (Patient/Family Teaching)

Implementation

Patient/Family Teaching

• Instruct patient and caregiver that medication should be taken as directed.
• Advise patient and caregiver to notify health care professional if nausea, vomiting, anorexia, and weight loss occur.

Evaluation/Desired Outcomes

• Temporary improvement in cognitive function (memory, attention, reasoning, language, ability to perform simple tasks) in patients with Alzheimer's disease.