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Drugs for AD
Drugs for Alzheimer's Disease
Question | Answer |
---|---|
Alzheimer's disease: risk factor (major one) | Advancing age; onset is usually 65 years old |
Alzheimer's disease: risk factors | Family hx, female, production of apoE4, high levels of homocysteine, low levels of folic acid |
Alzheimer's disease: mild symptoms | Memory loss, confusion, disorientation, problems with routine tasks, changes in judgement and personality |
Alzheimer's disease: moderate symptoms | Difficulty with ADLs, anxiety, suspiciousness, agitation, sleep disturbances, wandering pacing, difficulty recognizing family and friends |
Alzheimer's disease: severe symptoms | Loss of speech, loss of appetite, weight loss, loss of bladder and bowel control, total dependence on caregiver |
Alzheimer's disease: cholinesterase inhibitors drugs | Donepezil, galantamine, rivastigmine, and tacrine |
Alzheimer's disease: NDMA antagonist | Memantine |
Cholinesterase inhibitors: mechanism of action | Prevents breakdown of Ach by AchE, increasing availability of Ach at cholinergic synapses |
Cholinesterase inhibitors: uses | Mild to moderate symptoms |
Cholinesterase inhibitors: adverse effects | Anticholinergic effects in periphery, bronchoconstriction, bradycardia |
Cholinesterase inhibitors: drug interaction that reduces therapeutic effects | Drugs that block cholinergic receptors |
Cholinesterase inhibitors: drug interactions | Antihistamine, tricyclic antidepressants, antipsychotics |
Tacrine: mechanism of action | Reversible inhibition of AchE |
Tacrine: adverse effect | Liver damage |
Tacrine: disadvantage | Dosing is 4 times a day |
Donepezil: mechanism of action | Reversible inhibition of AchE |
Donepezil: adverse effects | Better tolerated. nausea, diarrhea, bradycardia |
Memantine: mechanism of action | Blocks calcium influx when glutamate is low, and permits calcium influx when glutamate is high |
Memantine: uses | Moderate to severe AD |
Memantine: pharmacokinetics | Renal excretion. Contraindicated in patients with severe renal impairment |
Memantine: adverse effects | Dizziness, headache, confusion, constipation |
Memantine: drug interaction that increases therapeutic effects | NMDA antagonist, sodium bicarbonate |