NURS 6630 Week 10 Dementia Treatment – Ulcius

NURS 6630 Week 10 Dementia Treatment

NURS 6630 Week 10 Dementia Treatment

In the last decade, research has focused on developing novel medications for the treatment of dementia. Cannabinoids are one of the potential agents under investigation. The present study aimed to examine the evidence concerning the effectiveness of cannabinoids for the treatment of dementia.

NURS6630 Week 10 Assignment: Assessing and Treating Clients With Dementia

The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.

Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from

http://www.alz.org/what-is-dementia.asp

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Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 13, “Dementia and Its Treatment”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

For insomnia

donepezil

galantamine

memantine

rivastigmine

Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

Note: Retrieved from from the Walden Library databases.

Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf

Required Media

Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.

Note: This case study will serve as the foundation for this week’s Assignment.

To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.

The Assignment : NURS 6630 Week 10 Dementia Treatment

Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Objective: In the last decade, research has focused on developing novel medications for the treatment of dementia. Cannabinoids are one of the potential agents under investigation. The present study aimed to examine the evidence concerning the effectiveness of cannabinoids for the treatment of dementia.

Methods: We undertook a systematic review complying to PRISMA guidelines. Four databases were searched including Medline, Embase, Cochrane Library, and PsychINFO.

Results: Five studies evaluated the use of cannabinoids for anorexia and agitation in dementia. One study used dronabinol 5 mg/day to target anorexic symptoms of dementia which positively impacted on weight. Results of two trials investigating the effectiveness of tetrahydrocannabinol (THC) 1.5–4.5 mg/day for the treatment of agitation indicated no significant differences between THC and placebo. The most recent trial reported significant improvement in agitation using nabilone at 1–2 mg/day. However, levels of evidence of these agents were rated as low and very low because of low sample size and methodology issues. No studies were available that investigated the use of cannabinoids to moderate cognitive symptoms in dementia.

Conclusions: Findings from a few robust randomized controlled trials suggest that nabilone might be useful for the treatment of agitation in patients with dementia, but there is no convincing evidence for THC. Additional studies are needed to further clarify and assess the benefits of these treatments.

Clinical Implications: There were no randomized controlled trials investigating the use of cannabinoids for the treatment of cognitive decline in dementia. Studies on THC reported no significant improvement in agitation. It may be too early to postulate that cannabinoids have any effect on dementia symptoms or their progression.