Alzheimer's Disease: Medications and Strategies (Nursing)

00:01 So there are medications.

00:03 Medications are usually related to whatever stage of disease the person is in, and what we're trying to do is we're trying to keep that person from losing more of their capabilities.

00:18 So in that mild or moderate arena, we are looking at things like Aricept.

00:27 We're looking at some of the other medications, Exelon.

00:33 These are medications that help the person to refresh memory, to stay cogent.

00:41 When it gets to moderate or severe, we're now looking at Namenda.

00:46 We're looking at Aricept again and some antidepressants.

00:51 If the mood is very labile, we may also be considering anticonvulsants and mood stabilizers.

00:59 Remember when when we are going to be treating persons with Alzheimer's disease, the medications treat the symptoms.

01:07 You are not going to be treating Alzheimer's itself because this is a progressive chronic brain disease.

01:15 And so we're not treating the brain itself.

01:18 What we're treating is to help the person with the symptoms that they're trying to live with.

01:25 Controversial treatments for Alzheimer Disease include Aducanumab (Aduhelm) and Vitamin E. Aducanumab is a monoclonal antibody directed against amyloid beta and has received FDA approval for use in mild Alzheimer cases.

01:40 Alzheimer cases.

01:41 It's particularly adept at reducing amyloid levels in the brain, which is a hallmark of the disease.

01:47 However, it's important to note that we do not have solid evidence that this reduction translates into clinical benefits for patients.

01:54 There are also risks associated with Aducanumab, necessitating close monitoring, , including both clinical and imaging assessments.

02:03 Therefore, its routine use is not currently recommended, and it is graded 2C.

02:09 Treatment with Aducanumab should be a shared decision between the patient and physician, weighing the potential benefits against the known risks and considering the uncertainties involved.

02:19 When it comes to Vitamin E, this is an option we might consider for those with mild to moderate AD.

02:25 At a dose of 1000 international units twice daily, Vitamin E might slow disease progression, although any benefit is likely modest. It's not universally endorsed by experts, particularly due to concerns about risks in patients with existing cardiovascular conditions.

02:43 Now, there are some environmental and therapeutic strategies.

02:48 These strategies are going to be delivered by professionals who have, as their professional training, a well known body of tools.

03:01 For example, occupational therapists will be working to help the person to keep dexterity.

03:09 We may have Milieu therapy where they're going into a situation like the hospital or perhaps an extended care facility for persons who have dementia, where the whole environment is set up to increase their functioning and to slow down this progression of loss.

03:33 We're also thinking about family education because a person who has spent their lifetime being the head of the family is now going to require quite a bit of support.

03:45 And so family education to learn how to keep the person safe and to make sure that they're doing everything that they can to keep them at their highest functioning level.

03:57 And it is very exhausting for the family and the caregivers who's taking care of a person who has dementia, who has Alzheimer's disease.

04:07 And so we want to make sure that we are finding the resources in the community so that the caregiver will also have the support that are needed.