Drug treatment of Alzheimer's disease

Article Abstract:

Alzheimer's disease (AD) is a complex disorder affecting numerous hormones and nervous system components. It causes memory loss, and also leads to personality and neuromuscular changes, seizures, and sometimes psychosis. It has been estimated that almost half of those over 85 years of age have AD. Medications are now being tested to improve either cognitive function or behavior. The drugs to improve cognition either enhance the function of neurotransmitters or otherwise affect the function of neurons, or they affect the circulatory system. Other drugs under consideration affect other systems. Acetylcholine regulates the messages passing between nerve cells that store and retrieve information in memory. Nootropic drugs increase the activity of neurons, and these may help some patients with AD. Oxiracetam may help mitigate the effects of sedatives, including diazepam, phenobarbital sodium, and scopolamine, but it has recently been withdrawn from trials. Vasodilators (agents that improve blood flow by widening blood vessels) may also reduce the symptoms of AD. Ergot-type drugs and the calcium channel blockers are currently being tested. The role of calcium is not well understood, and low levels in the diet may play a role in the development of AD. Among other types of drugs under consideration are selegiline, a monoamine oxidase (MAO) B inhibitor. MAO inhibitors are often used to treat depression, and selegiline is used to treat Parkinson's disease. Other ''miscellaneous'' drugs have not been successful so far. Among drugs affecting behavior, neuroleptics (sedatives) are the most common, and probably the most overused, especially in nursing homes, despite physician education and guidelines for use. Drugs to control anxiety (benzodiazepines and barbiturates) are commonly prescribed, but should not be used for longer than one week. Carbamazepine, an antirage drug, has been used successfully to treat agitation and violent behavior. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Alzheimer's disease, Tranquilizing drugs, Tranquilizing agents, Vasodilators, Vasodilator agents, Antipsychotic drugs, Antipsychotic agents, Anti-Alzheimer's disease agents

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Successful treatment of primary amebic meningoencephalitis

Article Abstract:

Primary amebic meningoencephalitis (PAM) is an unusual disease, which is caused by infection with the ameba Neigleria fowleri. The organism is found in fresh water and soil, and typically infects swimmers. Only three people have previously been reported to survive this devastating infection. A fourth survivor is described. A 32-year-old healthy man was admitted to the hospital with apparent meningitis (inflammation of the membrane covering the brain and spinal cord), accompanied by fever and headache, and he quickly went into a coma. A spinal tap showed pus in his spinal fluid, and because he had worked as a swimming instructor, a special stain of the fluid for testing amebae was requested. Penicillin was begun immediately, but within a few hours, a report was available that described the presence of living amebae in the patient's spinal fluid. Treatment was immediately changed to a combination of the drugs amphotericin B and rifampin, which was continued for 10 days. At the end of the course of treatment, the patient was symptom-free, and was discharged well. The case should serve as a reminder that a patient with apparent meningitis who has been swimming in freshwater lakes could have PAM, and the treatment of this differs markedly from that for a typical meningitis. Rapid institution of the appropriate therapy can produce cure, if PAM is recognized early enough. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Causes of, Protozoan diseases, Meningoencephalitis

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