AP ACE Acetylcholine



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The neurotransmitter that I received is acetylcholine (ACH). Acetylcholine (ACH) is created by two enzymes: choline and acetyl coenzyme A (AcCoA) are combined in the body to form the enzyme acetyltransferase (ChAT). Acetyltransferase (ChAT) produces the neurotransmitter acetylcholine (ACH) (Stahl, 2021). Without these enzymes in place, acetylcholine cannot be produced. Acetylcholine is important as it involves the sympathetic and parasympathetic nervous system. Acetylcholine plays a role in brain functions such as memory, motivation, learning, attention, arousal, muscle contractions, and REM sleep. Acetylcholinesterase (AChE) terminates the effect of ACH.  

Psychiatric Diagnoses 

Alzheimer’s Disease  

Symptoms – Excess or Deficiency?  

Symptoms of Alzheimer’s Disease include impaired memory, severe cognitive and behavioral symptoms, depression, anxiety, anger, irritability, insomnia, and paranoia (Kumar, et al., 2022). Often with Alzheimer’s as the disease progresses, severe cognitive and behavioral symptoms (irritability, paranoia) arise. These symptoms are due to a deficiency in acetylcholine. This is because acetylcholine is linked to the brain’s function of memory, learning, motivation, and muscle contractions. As a patient continues to have a deficiency with acetylcholine, the patient continues to have a decrease in memory, comprehension, reasoning, and judgment (Kumar, et al., 2022).  

Treatment – Drug Class/Agonists or Antagonists/Impact Discuss  

There is currently no cure for Alzheimer’s disease. Symptomatic treatment is often the plan of care for patients with Alzheimer’s disease. The common medication drug class is Cholinesterase Inhibitors. This medication increases the levels of acetylcholine by preventing the breakdown of acetylcholine (Kumar, et al., 2022). Cholinesterase Inhibitors are antagonists of acetylcholinesterase (AChE) as they inhibit this enzyme from breaking down acetylcholine (ACH). Examples of these drugs are Donepezil (utilized in all stages of Alzheimer’s disease), Galatamine, and Rivastigmine (approved for the dementia stage) (Kumar, et al., 2022). Unfortunately, cholinesterase inhibitors are not a cure for Alzheimer’s disease but are simply utilized to slow down the progression of the disease.  

Instructions– Engage by asking questions, and offering new insights, applications, perspectives, information, or implications for practice. Communicate using respectful, collegial language and terminology appropriate to advanced nursing practice. Communicate with minimal errors in English grammar, spelling, syntax, and punctuation. Use current APA format to format citations and references and is free of errors.  Provide 1 APA reference with a response within 5 years. 

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