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Pharmacology Case Study
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Pharmacology Case Study
Dementia is a neurodegenerative disorder that can significantly impact an individual’s quality of life. As the condition progresses, patients may experience memory loss, confusion, and behavioral disturbances, among other symptoms. While there is no cure for dementia, medications are available to help manage some of its symptoms (Soto-Gordoa, 2019).
One class of medications used for the treatment of dementia is cholinesterase inhibitors. These medications prevent the breakdown of acetylcholine, a neurotransmitter important for memory and cognitive function. Commonly used cholinesterase inhibitors are donepezil (Aricept) which is started at a low dose and gradually increased over time. Regular negative results of cholinesterase inhibitors include anorexia, insomnia, and muscle cramps. Rare but severe adverse effects include bradycardia, syncope, and seizures.
Another class of medications used to nurse dementia is N-Methyl-D-aspartate (NMDA) receptor antagonists. This treatment hinders over-triggering the NMDA sense organs, which can lead to neuronal damage. A commonly used NMDA receptor antagonist is memantine (Namenda). Memantine is typically started at a low dose and gradually increased over time, and it can be taken with or without food. Common adverse effects of memantine include dizziness, headache, and constipation. Rare but severe adverse effects include hallucinations and seizures.
Patients with dementia may also experience behavioral disturbances such as agitation, aggression, and hallucinations. Medications for managing behavioral disturbances in dementia are risperidone (Risperdal) and quetiapine (Seroquel). Risperidone is an atypical antipsychotic medication that can effectively manage agitation and aggression. Common adverse effects of risperidone include sedation and extrapyramidal symptoms (Ceylan et al., 2017). Quetiapine is also an atypical antipsychotic medication that effectively manages agitation and aggression. Common adverse effects of quetiapine include sedation, dizziness, and dry mouth.
Levodopa is a medication used in nursing for Parkinson’s disease. It is the precursor of dopamine, a neurotransmitter deficient in the brains of individuals having Parkinson’s disease. Levodopa is converted into dopamine inside the brain, which assists in relieving signs of Parkinson’s disease, like shaking and tension. Adverse effects of levodopa can include nausea, confusion, hallucinations, and dyskinesias (involuntary movements).
The drug most commonly combined with levodopa is carbidopa. Carbidopa is a medication that prevents the failure of levodopa prior to getting into the brain, allowing extra levodopa to be available for conversion to dopamine in the brain. This combination, known as carbidopa-levodopa, can help reduce the dosage of levodopa required and minimize its adverse effects. Other drugs that nurse Parkinson’s disease are dopamine agonists (such as pramipexole and ropinirole), which mimic the action of dopamine inside the brain, while monoamine Oxidase-B inhibitors (such as selegiline and rasagiline), add dopamine intensity by blocking the enzyme that breaks down dopamine in the brain ((Mohammed & Alenezi, 2020).
Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant that elevates serotonin and norepinephrine levels in the brain (Dean, 2020). It differs from tricyclic antidepressants (TCAs), which primarily increase the levels of norepinephrine and serotonin inside the brain. Venlafaxine is less likely to cause adverse outcomes like sedation and alimentary stoppage, commonly related to TCAs. However, extreme results of venlafaxine might comprise a lack of sleep, vomiting, anxiety, and sexual dysfunction.
References
Ceylan, M. F., Erdogan, B., Tural Hesapcioglu, S., & Cop, E. (2017). Effectiveness, adverse effects and drug compliance of long-acting injectable risperidone in children and adolescents. Clinical drug investigation, 37, 947-956.
Dean, L. (2020). Venlafaxine therapy and CYP2D6 genotype.
Mohammed, M., & Alenezi, S. K. (2020). Advancement and Challenges in Parkinson’s Disease: A Recent Outlook. Principles of Neurochemistry: Fundamentals and Applications, 157-170.
Soto-Gordoa, M. (2019). Dementia related neuropsychiatric symptoms: inequalities in pharmacological treatment and institutionalization.
QUESTION
Mrs. William, a 75-year-old patient is with her daughter for a follow-up visit. At her previous office visit, her daughter expressed concerns about her mother’s increasing forgetfulness. You send Mrs. William for neuropsychiatric testing. She is diagnosed with mild dementia, and the patient and family would like to discuss treatment options.
- Q1. Name a drug for each of the two classes of medication that is currently available for the treatment of dementia, and their adverse effects. (Trade and generic names).
- Q2. Mrs. William’s daughter is concerned about the behavioral disturbances that can be associated with progressive dementia. Discuss at least two disturbances associated with progressive dementia and their treatment recommendations. Please provide one medication, trade and generic name for each of the behavioral disturbances you list.
Mr. Lacy is a 65-year-old man diagnosed with Parkinson’s disease (PD) five years ago. His disease has progressed over the years, and it is recommended that he be treated with levodopa.
- Q3. What is levodopa, and how is it used in the treatment of Parkinson’s disease? What are the adverse effects of levodopa that might be expected in this patient?
- Q4. What drug is most commonly combined with levodopa and why?
- Q5. What other drugs can be used for the treatment of PD?
A 50-year-old man has developed depression after the death of his wife. He is prescribed venlafaxine (Effexor XR) 75 mg PO once a day.
- Q6. How does venlafaxine differ from tricyclic antidepressants (TCAs)? What adverse effects might this patient expect with venlafaxine?
Expectations
—–Citations: At least four high-level scholarly reference in APA from within the last 5 years
—–. com references not accepted please
—–Plagiarism free