Neurologic Disorders

The patient in this case study is a man named Mr. Akkad, who is 76 years old and was presented to the clinic by his son because he had been behaving in a strange manner. According to the results of his Mini-Mental State Exam, he has mild dementia. Specifically, he has difficulties with orientation, recollection, concentration, and calculating. He was given a diagnosis of Major neurocognitive disorder due to Alzheimer’s disease. Neurologic Disorders and Opioids Alzheimer Disease Essay Example

My first decision for Mr. Akkad was to have him take 1.5 milligrams of Exelon twice a day orally, with the goal of increasing his dosage to 3 milligrams in two weeks. After a period of four weeks, he underwent re-evaluation. At the subsequent appointment, the client’s symptoms were unchanged. The MMSE was performed on the individual, and there was no change in his score. The second decision was to raise the dosage of Exelon to 4.5 milligrams to be taken orally twice daily, with a further check-in scheduled for four weeks thereafter. At the subsequent appointment, the patient’s son reported that his father had been doing well with the medicine. On the other hand, the symptoms did not show any signs of improvement. A positive indicator of the client’s condition was that he had begun to attend religious services with his family. Because the client had a good response to the drug and had made some headway, it was prudent to keep the dosage the same and schedule a follow-up appointment for four weeks later. It was essential to ensure that the son fully understood that although the drug might temporarily alleviate symptoms, it would not address the underlying condition that was causing them.

In my opinion, the decisions that were taken were backed by evidence-based literature. According to the findings of several studies, there is currently no treatment that can reverse the effects of Alzheimer’s disease (Huang et al., 2020). Nonetheless, the optimal therapy for the symptoms may be developed with the support of the evidence-based practice. Cholinesterase inhibitors are currently the most effective medicine for treating mild to moderate cases of Alzheimer’s disease. Razadyne, Exelon, and Aricept are cholinesterase inhibitors that have been proven effective for Alzheimer’s disease symptoms like loss of memory and difficulty concentrating for extended periods of time (Sharma, 2019). They achieve their beneficial effects by inhibiting the synthesis of acetylcholine found in the brain. Neurologic Disorders and Opioids Alzheimer Disease Essay Example

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I was expecting that by making the decisions that were indicated above, I would be able to delay the progression of the symptoms and alleviate certain behavioral indicators, which would then allow the client to function normally. The client was given a prescription for Exelon, which is a cholinesterase inhibitor (Atri, 2019). His son indicated during the first follow-up appointment that the medicine was not doing anything to assist. Fortunately, following a dosage increase, the client started attending religious activities with his family by the time of the second follow-up. My expectations were that the client would keep his mental abilities while seeing a reduction in the severity of his symptoms and an improvement in certain behavioral patterns. Since the client is now able to join in on religious activities with his family members, it is clear that the drug is having a positive effect. It may take many months of treatment with this medication before the symptoms are able to reach a stable state. It is essential to have a conversation about this matter with Mr. Akkad’s family.

Neurologic Disorders and Opioids: Alzheimer’s Disease

The case study presents a 76-year-old Iranian male patient who presumably has been diagnosed with Alzheimer’s. The claim is grounded on his eldest son’s assertions and information on the disease history. No other organic ailments or processes were detected during the clinical tests and other examinations.  Two years ago, behavioral problems began, including personality changes, difficulty finding the perfect words during the discussion, memory loss, and extensive apathy. Confabulation is also observed during the physical examination, diagnostic interview, and conversation and when the patient reports being in a dysphoric state. Additionally, the patient exhibits impaired insight, judgment, and poorly coordinated impulse control. There is no incidence of suicidal ideations. Ultimately, Alzheimer’s disease-related neurocognitive impairment is clinically determined as Mr. Akkad’s precise diagnosis.

Various therapeutic decisions would be formulated to alleviate and possibly treat Mr. Akkad’s underlying health pathology. The initial approach entails recommending Mr. Akkad take Donepezil 5mg, notably a few hours before retiring to time. Over the years, Donepezil has been researched in patients with Alzheimer’s disease to evaluate its effectiveness. Being an acetylcholinesterase inhibitor, Donepezil plays an integral role in compensating for cholinergic neurons’ decreased functionality and bolstering the brain’s acetylcholine levels (American Academy of Family Physicians, 2019). Moreover, a meta-analysis of clinical studies examined the effect of Donepezil on individuals with Alzheimer’s disease.

The findings indicate that Donepezil is helpful in three important treatment areas for this illness, including functional capacity, behavioral modification, and cognition (Breijyeh & Karaman, 2020). These are the primary aspects of the patient’s condition that would be significantly impacted. The objective would be to minimize their influence on his life’s quality and enhance independence in the performance of activities of daily living. As evidenced in the case, significant personality changes negatively affected his participation in interested and pleasurable activities. However, it is necessary to highlight Breijyeh and Karaman’s (2020) assertion that limited data compares the most effective pharmacological agents in approaching Alzheimer’s disease, notably regarding the first-line therapeutic approaches.

The results of donepezil usage are variable due to the possibility of developing undesirable side effects and limited therapeutic advantages. The patient would complain of common adverse effects, including anorexia, vomiting, weight loss, and donepezil-induced diarrhea. The second option would entail incorporating cognitive behavioral therapy into the patient’s treatment regimen (Linn et al., 2020). In various clinical trials, this psychological treatment approach is beneficial for patients with Alzheimer’s disease, notably in its initial stages.  Neurologic Disorders and Opioids Alzheimer Disease Essay Example

Evidence capitalizing on psychosocial therapies for Alzheimer’s patients has been identified in a few isolated instances. However, actual evidence for these techniques is currently few. According to some researchers, behavioral therapies are acceptable for individuals with neuropsychiatric disorders. As a result, they are prescribed to patients to enhance their behavior, increasing their self-control and alleviating apathy (Rosenthal & Burchum, 2021). The improved mood benefits the patient’s quality of life and capacity to engage in cognitively beneficial engagements.

Thirdly, the inclusion of family members into the treatment process would be proposed to reaffirm and maintain beneficial habits. According to the American Academy of Family Physicians (2019), older adults have a high rate of non-adherence to health care interventions. This impairs the capacity to evaluate the efficacy of therapies, as poor prognosis may be attributable to ineffective medication usage. The objective is to strengthen Mr. Akkad’s support system and daily physical and social engagements. Rosenthal and Burchum (2021) posit that this approach has improved emotional and cognitive well-being among dementia patients. The results in the exercise significantly match the expected outcomes per the proposed decisions. These decisions would optimally enhance the patient’s health outcomes and alleviate the disease’s impact on their quality of life.

References

American Academy of Family Physicians. (2019). Dementia. Retrieved from http://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

Breijyeh, Z., & Karaman, R. (2020). A comprehensive review on Alzheimer’s disease: Causes and treatment. Molecules, 25(24), 5789.

Linn, B. S., Mahvan, T., Smith, B. E. Y., Oung, A. B., Aschenbrenner, H., & Berg, J. M. (2020). Tips and tools for safe opioid prescribing. The Journal of family practice, 69(6), 280-292.

Rosenthal, L., & Burchum, J. (2021). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book (2^nd Edition) Elsevier Health Sciences.

Neurologic Disorders and Opioids Alzheimer Disease Essay Example