Medical Surgical Alzheimer’s Disease #3

Question

A family member of an Alzheimer’s client requests something called in for her mother’s drainage and cough. The client is taking memantine. Which prescription should the nurse question?

Answers

  1. Guaifenesin
    • Rationale:

      This answer is not correct because guaifenesin is an expectorant and there are no drug interactions with memantine. An expectorant thins out mucus so the client can cough more productively.

  2. Honey
    • Rationale:

      This answer is not correct because honey is considered a natural expectorant. It has been known to soothe coughs due to its thickness and has no interactions with any medications.

  3. Dextromethorphan
    • Rationale:

      This answer is correct because dextromethorphan is an NMDA antagonist, as is memantine. They block NMDA glutamate receptors; memantine to improve cognitive and memory deficits and dextromethorphan to reduce coughing mechanisms. Administering memantine with dextromethorphan may increase adverse CNS effects such as dizziness and agitation and for this reason they should not be used together.

  4. Mentholated topical ointment
    • Rationale:

      This answer is correct because when applied to the skin, mentholated topical ointment is used to relieve coughing. It works by opening your airways to help you breathe more easily, thus easing coughing and is safe to take with memantine.

Overview

Memantine and Dextromethorphan are both NMDA antagonists. They block NMDA glutamate receptors; memantine to improve cognitive and memory deficits and dextromethorphan to reduce coughing mechanisms.

Explanation

Learning Outcomes

Memantine and dextromethorphan are NMDA antagonists. They block NMDA glutamate receptors. Memantine improves cognitive and memory deficits. Dextromorphan as an antitussive agent to reduce the coughing mechanism. Administering memantine with dextromethorphan may increase adverse CNS effects such as dizziness and agitation. Coadministering these two drugs may increase Alzheimer’s symptoms. For these reasons, it is not recommended and should be questioned, if prescribed.

Test Taking Tip

Be on alert for medication interactions, especially with conditions of the brain.

Video Rationale