Scenario
Mike is 78 years old and has Alzheimer’s disease. Mike’s second wife, Christine looks after the everyday issues in the house such as bills and planning day-to-day activities. Mike has two grown up children, a son and a daughter, his daughter, Jane, lives locally, and his son, Matt, lives in Australia.
Mike has been on his current treatment for approximately six months, but recently has started to show signs of deterioration. He has moderate to severe cognitive impairment, with changes in his behaviour. He has started to become more agitated and irritable with those around him, and got lost on his way back from the park in the housing estate where he lives.
He is currently prescribed the following medication:
Rivastigmine 6mg twice a day
Discuss what you consider to be the key points in the scenario relating to Mike and the role of the nurse in his medicines management. Is there a pharmacological intervention that could help his cognitive decline?
Discuss the pharmacodynamic effects of rivastigmine. You should include therapeutic effects, side effects and possible interactions with other drugs.
Using the mnemonic ADME discuss the pharmacokinetics of rivastigmine. Consider the practical application when managing a patient on rivastigmine, including effects on dosing and possible drug interactions with other drugs.
(Approx 1000 words)
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