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Drugs for AD

Drugs for Alzheimer's Disease

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
Created by: suezy



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