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Related Concept Videos

Drug Therapy01:28

Drug Therapy

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
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Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance01:23

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The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
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Alzheimer's Disease: Treatment01:22

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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Dementia01:30

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Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
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Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists01:30

Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists

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Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
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Parkinson's Disease: Treatment01:24

Parkinson's Disease: Treatment

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Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
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Related Experiment Video

Updated: Sep 19, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Central Nervous System Polypharmacy Among People Living With Dementia.

Elizabeth A Bayliss1, J David Powers2, Linda A Weffald3

  • 1Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA; Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA.

Journal of the American Medical Directors Association
|June 3, 2025
PubMed
Summary

Deprescribing education did not reduce central nervous system (CNS) polypharmacy in persons with dementia. Individuals with cognitive limitations and multiple health conditions treated for mood or pain are at risk for CNS polypharmacy.

Keywords:
Polypharmacydementiadeprescribing

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Area of Science:

  • Gerontology
  • Clinical Pharmacy
  • Health Services Research

Background:

  • The Centers for Medicare and Medicaid Services Polypharmacy-CNS (Poly-CNS) quality metric aims to reduce risky prescribing for persons living with dementia (PLWD).
  • Polypharmacy, the use of multiple medications, is common in PLWD and can lead to adverse central nervous system (CNS) effects.

Purpose of the Study:

  • To evaluate the impact of deprescribing education on the prevalence of CNS polypharmacy in PLWD.
  • To identify patient characteristics associated with meeting Poly-CNS criteria.

Main Methods:

  • Secondary analysis of the Optimize cluster randomized pragmatic trial data.
  • Two cohorts of PLWD taking 5+ chronic medications were analyzed: a full intervention cohort and a clinician education cohort.
  • Generalized linear mixed models were used to assess the odds and trends of meeting Poly-CNS criteria over time.

Main Results:

  • No significant effect of the deprescribing intervention on the odds of meeting Poly-CNS criteria was observed in either cohort.
  • The proportion meeting Poly-CNS criteria at any time was 12.3% in the full intervention cohort and 10.8% in the clinician education cohort.
  • Younger age, greater morbidity, female sex, and hospice use were associated with meeting Poly-CNS criteria. Opioids, antidepressants, and gabapentin were commonly combined.

Conclusions:

  • Deprescribing education did not effectively reduce CNS polypharmacy in PLWD.
  • PLWD with cognitive limitations and multimorbidity, particularly those treated for mood and pain, are at high risk for CNS polypharmacy.
  • Further strategies are needed to address polypharmacy and its associated risks in this population.