Acetylcholine

The neurotransmitter that I received is acetylcholine (ACH). Acetylcholine (ACH) is created by two enzymes: choline and acetyl coenzyme A (AcCoA) are combined in the body to form the enzyme acetyltransferase (ChAT). Acetyltransferase (ChAT) produces the neurotransmitter acetylcholine (ACH) (Stahl, 2021). Without these enzymes in place, acetylcholine cannot be produced. Acetylcholine is important as it involves the sympathetic and parasympathetic nervous system. Acetylcholine plays a role in brain functions such as memory, motivation, learning, attention, arousal, muscle contractions, and REM sleep. Acetylcholinesterase (AChE) terminates the effect of ACH.

Psychiatric Diagnoses

Alzheimer’s Disease

Symptoms - Excess or Deficiency?

Symptoms of Alzheimer’s Disease include impaired memory, severe cognitive and behavioral symptoms, depression, anxiety, anger, irritability, insomnia, and paranoia (Kumar, et al., 2022). Often with Alzheimer’s as the disease progresses, severe cognitive and behavioral symptoms (irritability, paranoia) arise. These symptoms are due to a deficiency in acetylcholine. This is because acetylcholine is linked to the brain’s function of memory, learning, motivation, and muscle contractions. As a patient continues to have a deficiency with acetylcholine, the patient continues to have a decrease in memory, comprehension, reasoning, and judgment (Kumar, et al., 2022).

Treatment - Drug Class/Agonists or Antagonists/Impact Discuss

There is currently no cure for Alzheimer’s disease. Symptomatic treatment is often the plan of care for patients with Alzheimer’s disease. The common medication drug class is Cholinesterase Inhibitors. This medication increases the levels of acetylcholine by preventing the breakdown of acetylcholine (Kumar, et al., 2022). Cholinesterase Inhibitors are antagonists of acetylcholinesterase (AChE) as they inhibit this enzyme from breaking down acetylcholine (ACH). Examples of these drugs are Donepezil (utilized in all stages of Alzheimer’s disease), Galatamine, and Rivastigmine (approved for the dementia stage) (Kumar, et al., 2022). Unfortunately, cholinesterase inhibitors are not a cure for Alzheimer’s disease but are simply utilized to slow down the progression of the disease.

Instructions- Engage by asking questions, and offering new insights, applications, perspectives, information, or implications for practice. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice. Communicate with minimal errors in English grammar, spelling, syntax, and punctuation. Use current APA format to format citations and references and is free of errors. Provide 1 APA reference with a response within 5 years.

Full Answer Section

     

Challenges of using cholinesterase inhibitors in patients with Alzheimer's disease

Cholinesterase inhibitors are generally safe and well-tolerated, but they can cause side effects such as nausea, vomiting, diarrhea, and insomnia. These side effects are usually mild and go away on their own. However, in some cases, they can be severe enough to warrant discontinuation of the medication.

Another challenge of using cholinesterase inhibitors is that they do not stop the progression of Alzheimer's disease. They can only slow down the progression of the disease and improve symptoms such as memory and cognitive function for a limited period of time.

Promising new treatments for Alzheimer's disease

There are a number of new treatments for Alzheimer's disease that are currently in development. Some of these treatments are targeting the amyloid plaques and beta-tau tangles that are hallmarks of Alzheimer's disease. Other treatments are targeting the inflammatory response that is thought to contribute to the disease process.

One of the most promising new treatments for Alzheimer's disease is aducanumab (Aduhelm). Aducanumab is a monoclonal antibody that targets amyloid beta. In clinical trials, aducanumab was shown to reduce amyloid beta plaques in the brain and slow down the progression of Alzheimer's disease. However, aducanumab has also been associated with serious side effects, such as amyloid-related imaging abnormalities (ARIA).

What can nurses do to support patients with Alzheimer's disease and their families?

Nurses can play a vital role in supporting patients with Alzheimer's disease and their families. Here are a few things that nurses can do:

  • Provide education and support to patients and their families about the disease, its treatment, and its management.
  • Help patients and their families to develop coping mechanisms and strategies for dealing with the challenges of Alzheimer's disease.
  • Advocate for patients and their families to ensure that they have access to the resources and support they need.

Nurses can also play a role in research on Alzheimer's disease. By participating in clinical trials, nurses can help to develop new and more effective treatments for the disease.

Conclusion

Alzheimer's disease is a devastating neurodegenerative disease that has no cure. However, there are a number of treatments available that can slow down the progression of the disease and improve symptoms. Nurses can play a vital role in supporting patients with Alzheimer's disease and their families, as well as in advancing research on the disease.

Sample Answer

   

Response

Your summary of acetylcholine (ACh) and its role in Alzheimer's disease is accurate and comprehensive. I am particularly impressed with your understanding of the pathophysiology of Alzheimer's disease and the mechanism of action of cholinesterase inhibitors.

I have a few questions to follow up on:

  • What are some of the challenges of using cholinesterase inhibitors in patients with Alzheimer's disease?
  • Are there any other promising new treatments for Alzheimer's disease that are currently in development?
  • What can nurses do to support patients with Alzheimer's disease and their families?