Dc Lm Sng (Nm 5)

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Bnh ALZHEIMER (AD)

c im bnh hc? Gim V no & mt TBTK Mng ngoi bo amyloid m ri trong TBTK Sinh bnh hc? Gi thuyt amyloid: Cc MNB amyloid (A + TBTK cht) & m ri l do tch t A trong no (amyloid ah s dn truyn BT & lm cht TBTK ln cn) Gi thuyt tau: Cu trc tau thay i cc protein tau dnh li to m ri (tau protein ca neuron gip vi qun n nh) GT cholinergic: Gim acetylcholine TBTK cht nhiu hn Chun on? in no Hnh nh hc CT scan, MRI, PET, SPECT, fMRI nh gi CN tm thn MMSE (VN), ADAS-Cog, SIB XN mu, dch no tu, test th khu gic

Triu chng: S mt tr nh (sm nht) &:

Mt tr nh hon ton Mt tp trung t tng St cn (ko gii thch c) Kh khn trong i ng Kh khn trong ngn ng, giao tip

Thuc tr Alzheimer
c ch CHOLINESTERASE (Nh-TB)
Tacrine Donepezil Rivastigmine 40-160 mg 5-10 mg 1,5-12 mg (chia 4 ln PO) (PO) (PO) c gan (CC: suy gan) RLTH Khng chuyn ha gan RLTH Galantamine 8-24 mg (chia 2 ln PO) i khng ca nicotinic receptor RLTH

i vn trn NMDA receptor (TB-nng)

Memantine 1,5-12 mg (PO) Khng chuyn ho gan Chng mt,nhc u,THA

Lm chm tin trin

Cao chit Ginkgo biloba Vitamin E Selegiline 40 mg x3 2000 IU 10 mg (PO) (chia 2 ln PO) (PO) c ch MAO-B (Parkinson)

NMDA = N-methyl D-aspartate Yu t nguy c: Mch mu: THA, T, RLLM, BMV, TBMMN Li sng: t giao tip, t vn ng, ch n khng hp l

Dc Lm Sng (Nm 5)

Mc phn t NINCDS-ADRDA: khng nh Alzheimer tng i 1 Suy gim tr nh, nhn thc: m thm, nng dn 2 Gim hot ng t nht 2 vng no 3 Khng RL thn kinh, tm thn 4 > 40 tui 5 Khng c NN khc: TBMMN, Parkinson

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