ILOILO DOCTORS’ COLLEGE

COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

Gabales, Audrie Allyson Gabales H. BSN 3F Case 2 Major Depression

INTRODUCTION

Alzheimer disease is a progressive brain disorder that has a gradual onset but causes an
increasing decline in functioning, including loss of speech, loss of motor function, and
profound personality and behavioral changes such as paranoia, delusions, hallucinations,
inattention to hygiene, and belligerence. It is evidenced by atrophy of cerebral neurons,
senile plaque deposits, and enlargement of the third and fourth ventricles of the brain. Risk
for Alzheimer disease increases with age, and average duration from onset of symptoms to
death is 8 to 10 years. Research has identified genetic links to both early- and late-onset
Alzheimer disease (Graziane & Sweet, 2017).

Alzheimer's disease is the most common form of dementia in North America (60 percent of all
dementias), Scandinavia, and Europe. Women are more likely than men to develop
Alzheimer's disease. Alzheimer's disease was found in 85.5 percent of those with dementia.
According to a 2015 survey by the Philippine Statistics Authority (PSA), senior citizens aged 60
and up accounted for 7.55 million of the country's 101 million people, or 7.5 percent.

OBJECTIVES

GENERAL OBJECTIVES
The students will be able to implement relevant knowledge, skills, and attitude in giving
health education to an Alzheimer’s patient at the conclusion of this course.

SPECIFIC OBJECTIVES
Knowledge:
▪ Identify Alzheimer's indicators and manifestations.
▪ Determine the elements that contribute to and induce Alzheimer's Disease.
▪ To develop a greater understanding of the appropriate medication process.
Skills:
▪ Determine the best treatment for Alzheimer's Disease.
▪ Impose an Alzheimer's discharge plan or health education plan.
▪ The accurate disorder, nursing intervention, and evaluation should all be recorded.
▪ To deliver patients with safe and effective treatment and medications.
Attitude:
▪ To develop a bond with both the patient and the rest of the family.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

▪ To recognize and evaluate one's own and others' spirituality.

▪ Career aspirations for professional growth, self-care, and continuous learning should
be developed.

PSYCHOPATHOLOGY

ETIOLOGY
Although the greatest risk factor for AD is increasing age, many environmental, dietary, and
inflammatory factors also may determine whether a person suffers from this cognitive
disease. AD is a complex brain disorder caused by a combination of various factors that may
include genetics, neurotransmitter changes, vascular abnormalities, stress hormones,
circadian changes, head trauma, and the presence of seizure disorders.

PATHOPHYSIOLOGY
The pathogenesis of AD is uncertain but the disease includes specific neuropathologic and
biochemical changes that interfere with neurotransmission. These changes consist of
neurofibrillary tangles (tangled masses of nonfunctioning neurons) and senile or neuritic
plaques (deposits of amyloid protein, part of a larger protein called amyloid precursor protein
in the brain). The neuronal damage occurs primarily in the cerebral cortex and results in
decreased brain size. Similar changes are found in the normal brain tissue of nonsymptomatic
older adults, although to a lesser extent. Cells that use the neurotransmitter acetylcholine
are principally affected by AD. At the biochemical level, the enzyme active in producing
acetylcholine, which is specifically involved in memory processing, is decreased.

Scientists have been studying complex neurodegenerative diseases such as AD and have
focused on two key issues: whether a gene might influence a person’s overall risk of
developing the disease, and whether a gene might influence some particular aspect of a
person’s risk, such as the age at which the disease begins (age at onset). There are genetic
differences in early- and late-onset forms of AD (Sherva & Kowall, 2015). Researchers are
investigating what predisposes people to develop the plaques and neurofibrillary tangles that
can be seen at autopsy in the brains of patients with AD. Understanding the complex ways in
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

which aging as well as genetic and nongenetic factors affect brain cells over time, eventually
leading to AD, continues to increase.

SYMPTOMATOLOGY
Memory

Everyone has occasional memory lapses, but the memory loss associated with Alzheimer's
disease persists and worsens, affecting the ability to function at work or at home.

People with Alzheimer's may:

● Repeat statements and questions over and over

● Forget conversations, appointments or events, and not remember them later
● Routinely misplace possessions, often putting them in illogical locations
● Get lost in familiar places
● Eventually forget the names of family members and everyday objects
● Have trouble finding the right words to identify objects, express thoughts or take
part in conversations

Thinking and reasoning

Alzheimer's disease causes difficulty concentrating and thinking, especially about abstract
concepts such as numbers.

Multitasking is especially difficult, and it may be challenging to manage finances, balance

checkbooks and pay bills on time. Eventually, a person with Alzheimer's may be unable to
recognize and deal with numbers.

Making judgments and decisions

Alzheimer's causes a decline in the ability to make reasonable decisions and judgments in
everyday situations. For example, a person may make poor or uncharacteristic choices in
social interactions or wear clothes that are inappropriate for the weather. It may be more
difficult to respond effectively to everyday problems, such as food burning on the stove or
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

unexpected driving situations.

Planning and performing familiar tasks

Once-routine activities that require sequential steps, such as planning and cooking a meal or
playing a favorite game, become a struggle as the disease progresses. Eventually, people with
advanced Alzheimer's often forget how to perform basic tasks such as dressing and bathing.

Changes in personality and behavior

Brain changes that occur in Alzheimer's disease can affect moods and behaviors. Problems
may include the following:

● Depression
● Apathy
● Social withdrawal
● Mood swings
● Distrust in others
● Irritability and aggressiveness
● Changes in sleeping habits
● Wandering
● Loss of inhibitions
● Delusions, such as believing something has been stolen

Preserved skills

Many important skills are preserved for longer periods even while symptoms worsen.
Preserved skills may include reading or listening to books, telling stories and reminiscing,
singing, listening to music, dancing, drawing, or doing crafts.

These skills may be preserved longer because they are controlled by parts of the brain
affected later in the course of the disease.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DIAGNOSTIC AND LABS

LABORATORY TEST RESULTS NORMAL VALUES SIGNIFICANCE

ALBUMIN 3.6g/dL 3.6 - 5 g/dL NORMAL

TOTAL PROTEIN 6.8g/dL 6.3 - 8.2 g/dL NORMAL

ALKALINE PHOSPHATASE 41 U/L 38 - 126 U/L NORMAL

ALANINE TRANSAMINASE 21 U/L 7 - 58 U/L NORMAL

ASPARTATE AMINOTRANSFERASE 21 U/L 7 - 58 U/L NORMAL

(AST)

BILIRUBIN 0.3 mcg/dL 0.2 - 1.3 mcg/dL NORMAL

BLOOD UREA NITROGEN (BUN) 11 mg/dL 8 - 25 mg/dL NORMAL

HEMOGLOBIN (HgB) 13.5 g/dL 13.2 - 15.2 g/dL NORMAL

SERUM CREATININE (SCr) 0.7 mg/dL 0.5 - 1.4 mg/dL NORMAL

HEMATOCRIT (Hct) 39 % 40 - 52 % DECREASED AN

INSUFFICIENT SUPPLY
OF HEALTHY RED
BLOOD CELLS
(ANEMIA).
A LARGE NUMBER OF
WHITE BLOOD CELLS
DUE TO LONG TERM
ILLNESS.

SODIUM (Na+) 136 mEq/dL 134 - 146 mEq/dL NORMAL

PLATELET COUNT 300,000/mm2 140 - 450 mm3 NORMAL

CONFIDENCE INTERVAL (CI) 103 mEq/dL 98 - 107 mEq/dL NORMAL

WHITE BLOOD CELLS (WBC) 8700mm2 4.1 - 10.9 mm3 NORMAL

BICARBONATE 24 mEq/dL 22 - 26 mEq/dL NORMAL

ERYTHROCYTE SEDIMENTATION 17 mm/hr < 30 mm/hr NORMAL

RATE (ESR)
 ILOILO DOCTORS’ COLLEGE
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LABORATORY
RESULT NORMAL VALUES SIGNIFICANCE
EXAM
Bicarb 24 mEq/dL 22-26 mEq/dL Normal
ESR 17 mm/hr <30 mm/hr Normal
Glucose 101 mg/dL 65-110 mg/dL Normal
B12 452 pg/ml 223 - 1132 pg/ml Normal
Ca 8.5 mEq/dL 8.9 - 10.4 mEq/dL Hypocalcemia
Folate 6.4 ng/dL 3.6 - 20 ng/dL Normal
Mag 1.9 mEq/dL 1.6 - 2.4 mEq/dL Normal
Free Thyroxine
6.3 4 - 11 Normal
Index
Phos 3.3 mg/dL 2.5 - 4.5 mg/dL Normal
T3 101 ng/dL 75 - 220 ng/dL Normal
Cholesterol 160 mg/dL <200 mg/dL Normal
T4 6.1 mEq/dL 4 - 11 mEq/dL Normal
0.35 - 6.2 micro
TSH 2.0 micro unit/uL Normal
unit/uL
RPR Non-reactive _____ Normal

Radiology Testing
✔ CT Scan Impression - Mild Cortical Atrophy
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

NURSING CARE PLAN

Defining Characteristics Nursing Diagnosis Outcome Nursing Rationale Evaluation

Identification Interventions
Subjective: Long Term: Independent: Goals partially met.
After 24 hours of Assess patient for Determines type
“Manog 4 na ka tuig nga Chronic confusion related to nursing reversible or and extent of Long Term:
nabudlayan si papa mag Alzheimer’s Disease as intervention, irreversible dementia to After 24 hours of
recall” as verbalized by the evidenced by memory patient will dementia, causes, establish a plan of nursing
patient’s folk. impairment. exhibit minimal or ability to interpret care to enhance intervention, patient
reduced environment, cognition and partially exhibited
confusion, intellectual emotional minimal or reduced
memory loss, and thought functioning at confusion, memory
cognitive processes, optimal levels. loss, and cognitive
disturbances, memory loss, disturbances,
depending upon disturbances with depending upon
stage of AD. orientation, stage of AD.
Objective: behavior, and
● Forgetful socialization.
● Often does not Rationale:
remember his Alzheimer's disease causes Utilize cognitive Identifies current
grandson progressive damage to brain function testing level of dementia.
● Personality change cells, which is the primary
according to his cause of memory loss and Short Term: Maintain Prevents patient Short Term:
daughter confusion. As Alzheimer's After 8 hours of consistent agitation, erratic After 8 hours of
● He is unable to care disease and other nursing scheduling with behaviors, and nursing
for his home and non-curable cognitive intervention, allowances for combative intervention, patient
household chores, disorders progress, abilities patient will have patient’s specific reactions. partially had
and he is occasionally deteriorate, including the minimal needs, and avoid Scheduling may minimal confusion,
slow to respond to ability to perform activities confusion, frustrating need revision to cognitive
questions. required for independent cognitive situations and show respect for impairment, and
living. impairment, and overstimulation. the patient’s other dementia
other dementia sense of worth manifestations.
manifestations. and to facilitate
 completion of
tasks.

Note: Nursing Diagnosis Avoid or Catastrophic

should be base from (NANDA- terminate emotional
Approved Nursing Diagnosis) emotionally response are
charged situations prompted by task
or conversations. failure when the
Avoid anger and patient feels
expectation of expected to
patient to perform beyond
remember or ability and
follow becomes
instructions. Do frustrated and
not expect more angry. Responding
than the patient is calmly to the
capable of doing. patient validates
feeling and causes
less stress.

Provide time for Allows for

reminiscing if memory of past
patient so desires. pleasant events.
Patient may be
reliving events in
the past and the
caregiver should
identify this
behavior and
respect it.

Dependent:
Administer as
indicated:
● Aricept 5mg Aricept is thought
qd at to increase
bedtime. acetylcholine
8PM levels in the brain
by preventing the
breakdown of
acetylcholine.
This can increase
the
communication
between
remaining healthy
nerve cells in the
brain, and provide
a temporary
reprieve from
dementia linked
to Alzheimer's by
improving
cognition and
function.
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DRUG STUDY

Drug Name Classification and Indications and Side Effects and Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Adverse Effects
.
Generic Name: Classifications Indications: ● severe stomach Check with your doctor Check physician's order
Prevacid for the treatment of pain immediately if you have
PHARMACOTHERA heartburn and other ● diarrhea stomach cramps, bloated Observe 10 rights
PEUTIC: Proton pump symptoms associated containing feeling, watery and
inhibitor. with GERD  blood severe diarrhea which BASELINE
Trade/ Brand Name: ● seizure may also be bloody ASSESSMENT
lansoprazole CLINICAL: Antiulcer (convulsions) sometimes, fever, nausea Obtain baseline lab
agent. ● difficulty or vomiting, or unusual values. Assess for
urinating tiredness or weakness. epigastric/abdominal
● blood in your Lansoprazole may pain, evidence of
Dosage: urine increase your risk of GI bleeding, ecchymosis.
30mg ● Swelling having fractures of the
● rapid weight hip, wrist, and spine. INTERVENTION/EVAL
gain UATION
Route: Contraindications ● Dizziness Monitor CBC,
Oral Actions: Hypersensitivity to ● fast or irregular hepatic/renal function
Inhibits the (H+,K+) lansoprazole, other heart rate tests.
–ATPase enzyme proton pump inhibitors. ● Shaking Assess for therapeutic
system blocking the Concomitant use with ● jerky muscle response (relief of GI
Frequency and Timing final step in gastric rilpivirine. movements symptoms). Question if
qd acid secretion. ● feeling jittery diarrhea, abdominal pain,
8 AM ● muscle cramps nausea occurs. Obtain C.
or spasms in difficile PCR test in pts
 your hands or with persistent diarrhea,
feet fever, abdominal pain.
● Coughing
● choking PATIENT/ FAMILY
sensation TEACHING
● joint pain • Do not chew, crush
● skin rash delayed-release capsules.
• For pts who have
Adverse effects: difficulty
o Constipation. swallowing capsules,
o Itching. open capsules, sprinkle
o Dizziness. granules on 1 tbsp. of
o A skin rash. applesauce, swallow
o Nausea. immediately.
o Diarrhea.
o Intense
abdominal pain.

Drug Name Classification and Indications and Side Effects and Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Adverse Effects
Side Effects: ● Antacids should .
Generic Name: Classifications Indications: o Nausea not be prescribed BASELINE
Aluminum ● Acid indigestion, o Constipation to a patient with a ASSESSMENT Assess
hydroxide/magnesium CLINICAL: Antacid, sour stomach, o Diarrhea previous allergy to sensitivity to magnesium.
hydroxide anticonvulsant, heartburn, upset o Headache antacid containing Antacid: Assess GI pain
electrolyte, laxative. stomach. o Low phosphate products in order (duration, location,
level to prevent quality, time of
hypersensitivity. occurrence, relief with
o Loss of appetite
Antacids should food, causative/
o Unusual
Trade/ Brand Name: be prescribed IM exacerbate factors).
tiredness
Mylanta
Actions:
Dosage: An antacid that reduces
30mL gastric acid by binding Contraindications
with phosphate in the ● Antacid:
intestine, and then is
Route: excreted as aluminum
Oral carbonate in feces.
Aluminum carbonate
may increase the
absorption of calcium
Frequency and Timing due to decreased serum
PRN phosphate levels. The
drug also has astringent ● Laxative:
and adsorbent
properties.
o Muscle caution to a Laxative: Assess for
weakness pregnant woman weight loss, nausea,
or lactating mother vomiting, and history of
Adverse Effects: as these drugs can recent abdominal surgery.
o Dizziness potentially harm Systemic: Assess renal
o Fainting the fetus or function, serum
o Black/tarry newborn. magnesium.
Appendicitis, stools ● They should also
symptoms of o Slow/shallow be used in extreme INTERVENTION/EVAL
appendicitis, breathing caution in patients UATION Antacid: Assess
ileostomy, o Slow/irregular with GI for relief of gastric
intestinal heartbeat obstruction, due to distress. Monitor renal
obstruction, o Mental/mood possible systemic function (esp. if dosing is
severe renal changes (such absorption. long term or frequent).
impairment. ● Antacids should Laxative: Monitor daily
as
be used cautiously pattern of bowel activity,
confusion)Deep
Appendicitis, in patients with stool consistency.
HF, colostomy, sleep renal disorders or Maintain adequate fluid
hypersensitivity, o Pain with those with intake. Systemic: Monitor
ileostomy, urination electrolyte renal function,
intestinal o Stomach/abdom imbalance, as magnesium levels.
obstruction, inal pain there can be an PATIENT/FAMILY
undiagnosed o Vomit that looks electrolyte TEACHING
rectal bleeding. like coffee disturbance while • Antacid: Take at least
Systemic: Heart grounds the drug attempts 2hrs apart from other
block, o Itching/swelling to neutralize medication. • Do not take
myocardial (especially of hydrochloric acid. longer than 2wks unless
damage, IV use the directed by physician. •
for For peptic ulcer, take 1
face/tongue/thro
pre-eclampsia/ec and 3hrs after meals and
at)
lampsia during at bedtime for 4–6 wks. •
the 2hrs prior to Chew tablets thoroughly,
delivery. followed by 8oz of water;
shake suspensions well. •
 Repeat dosing or large
doses may have laxative
effect. • Laxative: Drink
full glass (8oz) liquid to
aid stool softening. • Use
only for short term. Do
not use if abdominal pain,
nausea, vomiting is
present. • Systemic:
Report symptoms of
hypermagnesemia
(altered mental status,
difficulty breathing,
dizziness, fatigue,
palpitations, and
weakness)

Drug Name Classification and Indications and Side Effects and Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Adverse Effects
.
Generic Name: Classifications Indications: Occasional: ● Platelet/bleeding ● Do not use if a
Aspirin ● Analgesia, Fever ● GI distress disorders, vinegar-like odor is
PHARMACOTHERA ● Revascularizatio (including ● Severe noted (indicates
PEUTIC: n abdominal renal/hepatic chemical
Nonsteroidal salicylate. ● MI, Stroke (Risk distention, impairment, breakdown).
CLINICAL: Reduction) cramping, ● Dehydration, ● Assess history of
Trade/ Brand Name: Anti-inflammatory, heartburn, mild ● Erosive gastritis, GI bleed, peptic
Asaphen E. C. antipyretic, nausea); allergic ● Peptic ulcer ulcer disease, OTC
anticoagulant. reaction disease, use of products that
(including
 bronchospasm, ● Sensitivity to may contain
Dosage: pruritus, tartrazine dyes aspirin.
80mg urticaria). ● Assess type,
location, duration
Adverse effects/toxic of pain, and
Route: Contraindications reactions: inflammation.
Oral Actions: ● Hypersensitivity ● High doses of ● If given as
Inhibits to salicylates, aspirin may antipyretic, assess
cyclo-oxygenase NSAIDs. produce GI temperature
enzyme via acetylation. ● Aspirin triad bleeding and/or directly before and
Frequency and Timing Inhibits formation of (asthma, rhinitis gastric mucosal 1 hr after giving
qd prostaglandin [with or without lesions. medication.
8 AM derivative thromboxane nasal polyps], ● Evaluate for
A. aspirin therapeutic
intolerance). response: relief of
Therapeutic Effect: ● Do not use it for pain, stiffness,
Reduces inflammatory at least 7 days swelling; increased
response, intensity of after joint mobility;
pain; decreases fever; tonsillectomy or reduced joint
inhibits platelet oral surgery. tenderness;
aggregation. improved grip
strength.

Patient/family teaching
● Do not chew,
crush, dissolve, or
divide
enteric-coated
tablets.
 ● Avoid alcohol,
OTC pain/cold
products that may
contain aspirin.
● Report ringing of
the ears or
persistent
abdominal GI pain,
bleeding.
● Behavioral
changes, persistent
vomiting may be
early signs of
Reye’s syndrome;
contact physician.

Drug Name Classification and Indications and Side Effects and Special Precautions Nursing Responsibilities
Mechanism of Action Contraindications Adverse Effects

Generic Name: Classifications Indications: Rare: ● Sensitivity to ● If given for

Paracetamol/ ● Analgesia ● Hypersensitivity acetaminophen; analgesia, assess
Acetaminophen PHARMACOTHER ● Antipyresis reaction. severe renal onset, type,
APE UTIC: impairment; location, duration
Central analgesic. Adverse effects/toxic alcohol of pain.
reactions dependency, ● Effect of
CLINICAL: Early Signs of hepatic medication is
Trade/ Brand Name: Non-narcotic analgesic, Acetaminophen impairment, or reduced if full pain
Tylenol antipyretic. Toxicity: active hepatic response recurs
● Anorexia, disease. prior to the next
● Nausea, ● Limit dose to less dose.
● Diaphoresis, than 4 g/day. ● Assess for fever.
Dosage: Contraindications
325mg ● Hypersensitivity ● Fatigue within ● Assess for clinical
to the first 12–24 improvement and
acetaminophen. hrs. relief of pain, fever.
Route:
Oral Later Signs of Patient/family teaching
Toxicity: ● Consult a physician
Actions: ● Vomiting, for use longer than
Appears to inhibit ● Right upper 10 days (adults), or
Frequency and Timing prostaglandin quadrant fever lasting longer
PRN synthesis in the CNS tenderness, than 3 days.
and, to a lesser extent, ● Elevated LFTs ● Severe/recurrent
block pain impulses within 48–72 pain or
through peripheral hrs after high/continuous
action. Acts centrally ingestion. fever may indicate
on Antidote: serious illness.
hypothalamic heat Acetylcysteine
regulating center,
producing peripheral
vasodilation (heat
loss, skin
erythema,
diaphoresis).

Therapeutic Effect:
Results in antipyresis.
Produces analgesic
effect.
Generic Name: Classifications Indications: ● Nausea ● Antacids should ● If given for
Donepezil ● Aricept is ● Vomiting not be prescribed analgesia, assess
indicated for ● Diarrhea to a patient with a onset, type,
Acetylcholinesterase treatment of ● Loss of appetite previous allergy to location, duration
inhibitors, Central. dementia of ● Dizziness antacid containing of pain.
Alzheimer’s ● Drowsiness products in order ● Effect of
Trade/ Brand Name: type.Used to ● Weakness to prevent medication is
Aricept treat confusion. ● Trouble sleeping hypersensitivity. reduced if full pain
● Tremor or muscle Antacids should response recurs
cramps be prescribed IM prior to the next
● caution to a dose.
Dosage: ● pregnant woman ● Assess for fever.
5mg ● Adverse effects: or lactating mother ● Assess for clinical
● Trouble urinating as these drugs can improvement and
● Severe stomach potentially harm relief of pain, fever.
Route: pain the fetus or
Oral ● Black stools newborn. They Patient/family teaching
Actions: Contraindications ● Vomit that looks should also be ● Consult a physician
Aricept is a new like coffee grounds
This is contraindicated used in extreme for use longer than
reversible inhibitor of in patients with: ● Seizures
caution in patients 10 days (adults), or
Frequency and Timing the enzyme ● Low amount of ● Irregular heartbeat
with GI fever lasting longer
qd acetylcholinesterase. ● Fainting
obstruction, due to
magnesium & than 3 days.
8PM Acetylcholinesterase is ● Severe dizziness
possible systemic
potassium in the ● Severe/recurrent
an enzyme, which ● Itching & swelling
absorption.
blood. pain or
breaks down the Antacids should high/continuous
● Neuroleptic
neurotransmitter be used cautiously fever may indicate
acetylcholine. Aricept malignant
syndrome in patients with serious illness.
may allow a greater renal disorders or
concentration of ● Heart attack
those with
acetylcholine in the within last 30
electrolyte
brain, thereby days. imbalance, as
improving cholinergic ● Atrioventricular there can be an
function block, a type of electrolyte
 slow heart disturbance while
rhythm disorder the drug attempts
● Intestinal ulcer to neutralize
● Blockage of hydrochloric acid.
urinary bladder
 ILOILO DOCTORS’ COLLEGE
COLLEGE OF NURSING
West Avenue, Molo, Iloilo City

DISCHARGE PLAN

MEDICINES:

● Medicines can help you feel less anxious or depressed and more stable.
● Take your medicine exactly as prescribed. If you think your medicine isn't
working or if you're experiencing side effects, talk to your doctor. Tell him or
her if you have any drug allergies. Make a list of all the medications, vitamins,
and herbal supplements you're taking. Include the amounts you're taking, as
well as when and why you're taking them. To follow-up visits, bring the list or
the pill bottles. Keep a list of your medications on you at all times in case of an
emergency.

Self-care:

You may have a family member or friend who can help you with daily tasks. Your
healthcare provider can give you information on how to find someone if needed. The
person can help set up alarms or timers to remind you to eat, take medicines, and use
the bathroom. He or she may be able to help you prepare meals, bathe, and get to
appointments. The kind of help you need will change over time. The following can
help you manage AD:

● Place clocks and calendars where you can see them. This will help you
remember appointments and tasks.
● Keep activities the same from day to day. Take breaks often. Save difficult
activities for when you are the most alert. Choose activities you are interested
in doing.
● Keep mealtimes at the same time each day. Your healthcare providers can help
you create a meal plan.
● Create a bathroom schedule. An example is going every 4 hours.
● Limit the amount of liquid you drink in the evening. This may help you sleep
through the night. Try to go to bed at the same time every night.
 ● Keep your mind and body active. Call or visit people often. This will keep your
social skills sharp, and may help reduce depression. Do activities that you love,
such as art, gardening, or listening to music. Regular physical activity, such as
exercise, may help if you feel depressed or anxious. Exercise can also help you
sleep better.
● Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause
blood vessel damage. Ask your healthcare provider for information if you
currently smoke and need help to quit. E-cigarettes or smokeless tobacco still
contain nicotine. Talk to your healthcare provider before you use these
products.

RRL

Alzheimer’s disease (AD) is a neurodegenerative disorder that impairs mental ability

development and interrupts neurocognitive function. This neuropathological condition
is depicted by neurodegeneration, neural loss, and development of neurofibrillary
tangles and Aβ plaques. There is also a greater risk of developing AD at a later age for
people with cardiovascular diseases, hypertension and diabetes. In the biomedical
sciences, effective treatment for Alzheimer’s disease is a severe obstacle. There is no
such treatment to cure Alzheimer’s disease. The drug present in the market show only
symptomatic relief. The cause of Alzheimer’s disease is not fully understood and the
blood-brain barrier restricts drug efficacy are two main factors that hamper research.
Stem cell-based therapy has been seen as an effective, secure, and creative
therapeutic solution to overcoming AD because of AD’s multifactorial nature and
inadequate care. Current developments in nanotechnology often offer possibilities for
the delivery of active drug candidates to address certain limitations. The key
nanoformulations being tested against AD include polymeric nanoparticles (NP),
inorganic NPs and lipid-based NPs. Nano drug delivery systems are promising vehicles
for targeting several therapeutic moieties by easing drug molecules’ penetration
across the CNS and improving their bioavailability. In this review, we focus on the
causes of the AD and their treatment by different approaches.

Reference: Srivastava, S., Ahmad, R., & Khare, S. (2021). Alzheimer’s disease and its treatment by
different approaches: A review. European Journal Of Medicinal Chemistry, 216, 113320.
https://doi.org/10.1016/j.ejmech.2021.113320