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www.alzheimers.org.au Information on resources, medical treatments, outreach programs and local support groups involved with Alzheimer’s disease. www.myasthenia.org.au Home page of the Australian Myasthenic Association in NSW. Information and resources on myasthenia gravis and treatments. www.myastheniawa.info Home page of the Myasthenia Gravis Friends and Support Group, Western Australia. Information and resources on myasthenia gravis and treatments. Australian Institute of Health and Welfare (AIHW). (2013). Dementia, www.aihw.gov.au/dementia. Crouch, A. M. (2009). Treating dementia. Australian Prescriber , 32 , 9–12. Downey, D. (2008). Pharmacology update. Pharmacologic management of Alzheimer disease. Journal of Neuroscience Nursing , 40(1) , 55–59. Farrell, M. & Dempsey, J. (2014). Smeltzer & Bare’s Textbook of Medical-Surgical Nursing (3rd edn). Sydney: Lippincott Williams & Wilkins. Goodman, L. S., Brunton, L. L., Chabner, B. & Knollmann, B. C. (2011). Goodman and Gilman’s Pharmacological Basis of Therapeutics (12th edn). New York: McGraw-Hill. Grossberg, G. T., Pejovic, V. & Miller, M. L. (2007). Current strategies for the treatment and prevention of Alzheimer’s disease. Primary Psychiatry , 14(8) , 39–50, 51–54. Koch, J. A., Steele, M. R. & Koch, L. M. (2013). Myasthenia gravis. Journal of Gerontological Nursing , 39(12) , 11–15. McKenna, L. (2012). Pharmacology Made Incredibly Easy (1st Australian and New Zealand edn). Sydney: Lippincott Williams & Wilkins. McKenna, L. & Mirkov, S. (2014). McKenna’s Drug Handbook for Nursing and Midwifery (7th edn). Sydney: Lippincott Williams & Wilkins. Mestecky, A-M. (2013). Myasthenia gravis. British Journal of Neuroscience Nursing , 9(3) , 110–112. Mitchell, G. (2013). Applying pharmacology to practice: The case of dementia. Nurse Prescribing , 11(4) , 185–190. Porth, C. M. (2011). Essentials of Pathophysiology: Concepts of Altered Health States (3rd edn). Philadelphia: Lippincott Williams & Wilkins. Porth, C. M. (2009). Pathophysiology: Concepts of Altered Health States (8th edn). Philadelphia: Lippincott Williams & Wilkins. Reddel, S. W. (2007). Treatment of myasthenia gravis. Australian Prescriber , 30 , 156–160. Varner, M. (2013). Myasthenia gravis and pregnancy. Clinical Obstetrics & Gynecology , 56(2) , 372–381. BIBLIOGRAPHY

atony postoperatively or postpartum, and another agent is available to increase GI secretions and relieve the dry mouth of Sjögren’s syndrome. ■■ All indirect-acting cholinergic drugs are acetylcholinesterase inhibitors. They block acetylcholinesterase to prevent it from breaking down ACh in the synaptic cleft. ■■ Cholinergic stimulation by acetylcholinesterase inhibitors is due to an accumulation of the ACh released from the nerve ending. ■■ Myasthenia gravis is an autoimmune disease characterised by antibodies to the ACh receptors. This results in a loss of ACh receptors and eventual loss of response at the neuromuscular junction. ■■ Acetylcholinesterase inhibitors are used to treat myasthenia gravis because they allow the accumulation of ACh in the synaptic cleft, prolonging stimulation of any ACh sites that remain. ■■ Alzheimer’s disease is a progressive dementia characterised by a loss of ACh-producing neurons and ACh receptor sites in the neurocortex. ■■ Acetylcholinesterase inhibitors that cross the blood– brain barrier are used to manage Alzheimer’s disease by increasing ACh levels in the brain and slowing the progression of the disease. ■■ Side effects associated with the use of these drugs are related to stimulation of the parasympathetic nervous system (bradycardia, hypotension, increased GI secretions and activity, increased bladder tone, relaxation of GI and genitourinary sphincters, bronchoconstriction, pupil constriction) and may limit the usefulness of some of these drugs. Knowing your strengths and weaknesses helps you to study more effectively. Take a PrepU Practice Quiz to find out how you measure up! ONLINE RESOURCES An extensive range of additional resources to enhance teaching and learning and to facilitate understanding of this chapter may be found online at the text’s accompanying website, located on thePoint at http://thepoint.lww.com. These include Watch and Learn videos, Concepts in Action animations, journal articles, review questions, case studies, discussion topics and quizzes.

WEB LINKS

Healthcare providers and patients may want to consult the following Internet sources: www.aihw.gov.au/dementia Home page of the Australian Institute of Health and Welfare National Health Priority Area—Dementia.