Expert: Michalene Peticca - 11/18/2009

Question
QUESTION: Hi! I'm a student nurse and I want to know what post-op pain medications (Is it NSAIDs, acetaminophen or opioids) are commonly given to patients who undergone Partial Hip Replacement when they have Alzheimer's disease.

ANSWER: Hello Marie,

Thank you for writing.   That answer is generally left up to the Dr. who performed the hip replacement and also the Primary care physican of the Alzheimer's individual.

Due to allergies, medication reactions or interactions from exisitng medications, and overall ineffectiveness related to Alzheimer's disease, a physician may order either of these medications.

I think your asking perhaps which is Best to prescribe to a person with Alzheimer's disease?  Again, it is on an individual basis...but opioids are generally very strong and can have a long lasting effect with an individual with Alzheimer's disease.

Sorry, i am not a phyisican.   You may want to ask one of our fellow physicans on here what they most prescribe.

Best Regards,
Michalene Peticca, MA

---------- FOLLOW-UP ----------

QUESTION: Thank you for answering my question. So, why do you think opioids have a long lasting effect with an individual with AD? Does it have something to do with their low levels of Ach?

Answer
Hi Marie,
No, i think it has to do with the brain detoriation that occurs and the less "matter" of which the opiods have to "link" to.   It builds in the blood stream and is less likely to be able to flow through the body and release.

Again, i'm not a phyisican, and only offer my own opinion.  You would best be able to get some answers through an M.D.

Best Regards,
Michalene Peticca, M.A.



****That may be part of it....however, i still believe that because there has been deterioration of brain matter, that the exisiting matter is "overloaded" with opiod and thus creates almost an "overdose" effect in an Alzheimer's individual.