Neurologic Conditions: Alzheimer's Disease

Question 1

Natural products that may have benefit in Alzheimer’s

Answer 1

Vitamin E = 2,000 IU QD
Gingko

both inc bleeding risk

Question 2

Mainstay of Alzheimer’s txm

Answer 2

Acetylcholinesterase inhibitors

can add memantine (Namenda)

Question 3

Acetylcholinesterase inhibitor MOA

Answer 3

inhibits centrally-active acetylcholinesterase, enzyme responsible for hydrolysis of acetylcholine, leading to inc in acetylcholine

Question 4

Acetylcholinesterase inhibitors

Answer 4

Donepezil = Aricept
Rivastigmine = Exelon
Galantamine = Razadyne

Question 5

ACh-sterase inhibitor warnings

Answer 5

Cardiac effects, syncope, QT prolong
pts < 55kg can have more nausea/weight loss
NMS n rhabdo = rare

Question 6

ACh-sterase inhibitor side effects

Answer 6

Nausea
Diarrhea = dose related
insomnia
dec appetite and weight loss

Question 7

When can you switch to memantine from donepezil?

Answer 7

when stable on donepezil 10mg

Question 8

Memantine MOA

Answer 8

blocks NMDA receptors, inhibit glutamate from binding and dec abnormal neuron activation

Question 9

Memantine warnings

Answer 9

caution w/ drugs/conditions that inc urine pH, which will dec memantine clearance

Question 10

Memantine side effects

Answer 10

Well tolerated
Dizziness, confusion, headache, constipation, syncope

Question 11

Donepezil patch (Adlarity) info

Answer 11

apply same time each week, dont use same site within 14 days

remove from fridge and let get to room temp before using, have to use within 24hrs after removing from fridge