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Blog articles are provided as informational purposes only and are not intended to constitute medical advice. Medication protocols are subject to patient’s medical provider’s authorization.


There are currently three categories of dementia treatment medications:

Cholinesterase Inhibitors: donepezil (Aricept®), rivastigmine (Exelon®), galantamine (Razadyne®) – These medications increase levels of acetylcholine, a neurotransmitter in the brain, by preventing the enzyme acetylcholinesterase from breaking it down.

N-Methyl-D-Aspartate (NMDA) Receptor Antagonist: memantine (Namenda®) – Memantine blocks the NMDA type of glutamate receptor during periods of overstimulation.

Anti-Amyloid Monoclonal Antibody: aducanumab (Aduhelm®) – Aducanumab reduces the amyloid beta plaque deposits that occur in Alzheimer’s disease. The FDA granted accelerated approval for this medication on June 7, 2021, with continued approval contingent upon whether post-approval trials verify its clinical benefit. At this time, it is recommended for initiation only in the mild stage of dementia or cognitive impairment.


For healthcare workers, the toll of the COVID-19 pandemic has been indescribable. There have been few health events in modern times that have caught healthcare professionals as unprepared as the novel Coronavirus. There are roughly 28 million nurses working globally, constituting approximately 59% of the health sector and delivering up to 90% of care services. With regard to the hospice population, the strain on nurses is extraordinarily high.


“Drug interaction” generally refers to an interaction between two or more drugs that alter the performance of at least one of the interacting drugs.  Prescription and over-the-counter (OTC) medications, nutritional supplements, herbal products, foods, diagnostic agents, and other chemical substances have the potential to participate in interactions.  These interactions may alter medication absorption, distribution, metabolism, or elimination, which can, in turn, change their concentration, efficacy, or potential to cause adverse effects. Because drug interactions are so common, interactions are generally expressed in “levels of severity” to help identify the degree of risk.


Pruritus, also known as itching, is not the most common symptom seen in our patients at end of life, but it can be distressing and adversely affect quality of life. Pruritus can be described as an unpleasant sensation of the skin or mucous membranes that provokes the desire to scratch or rub. There are several chemical mediators, known as “pruritogens,” that are involved in the pathophysiology of itching. Although histamine is the best known pruritogen, there are several others, including serotonin, cytokines and opioids, that can play a role. This helps explain why not all itching sensations respond to treatment with antihistamines.


In the hospice setting, many healthcare practitioners are familiar with more common end-of-life symptoms.  These include pain, constipation, nausea and/or vomiting, anxiety, agitation, or dyspnea.  However, there are some less common symptoms that hospice patients may encounter, which may include hiccups, metallic (or bad) taste, and dizziness.


ANCC Accreditation

ProCare HospiceCare is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.