Pharmacology of Dementia (Wolff)

Question 1

What does donepezil reversibly and noncompetitively inhibits?

What effect does this have?

Answer 1

1) Acetylcholine esterase

2) Increases ACh concentration for synaptic transmission

Question 2

What is the clinical application for donepezil?

Answer 2

Alzheimer dementia

Question 3

What are potential toxicities of donepezil?

Answer 3

1) Altered cardiac conduction

2) Can worsen peptic ulcer, asthma, bladder outflow obstruction

Question 4

What is rivastigmine a reversible inhibitor of?

How can it be given?

Answer 4

1) AChE

2) Transdermal patch

Question 5

What is galantamine a reversible inhibitor of?

Answer 5

AChE

Question 6

What receptor is memantine an antagonist of?

What site does it bind to specifically?

Answer 6

1) NMDA receptor

2) Mg site

Question 7

What is the clinical application for memantine?

Answer 7

Alzheimer disease

Question 8

In the management of neuropsychiatric symptoms of dementia, why are antipsychotic agents not recommended?

Answer 8

They have limited efficacy and are associated with increased mortality

Question 9

Apathy which is a common and challenging symptom of dementia that can exist with and without comorbid depression can be treated with?

Answer 9

Cholinesterase inhibitor

Question 10

What are the most common clinical complication and source of treatment decisions in advanced dementia?

What are the second most common clinical complications?

Answer 10

1) Feeding problems

2) Recurrent infections