AlzheimersFC

Question 1

What is the most common type of dementia?

Answer 1

Alzheimer’s Disease

Question 2

What is an indication of impairment on the Mini-Mental State Exam?

Answer 2

<24

Question 3

What is the mainstay of therapy for AD?

Answer 3

Acetylcholinesterase inhibitors, such as donepezil

Question 4

natural products being used to treat dementia?

Answer 4

Vitamin E, Ginko, and Huperzine A, A-phosphaticylserine, acetyl-L-carnitine

Question 5

Main side effect you are worried about with Ginko?

Answer 5

Increases bleeding risk

Question 6

Drug interactions with acetylcholinesterase inhibitors?

Answer 6

Anti-muscarinic agents used for overactive bladder; can decrease efficacy of the dementia drug

Question 7

Donepezil

Answer 7

Aricept, Aricept ODT, Aricept high dose

Question 8

Rivastigmine

Answer 8

Exelon, Exelon Patch

Question 9

Galantamine
name
dose

Answer 9

Razadyne: 4-12 BID
Razadyne ER: 8 - 24 QD, start w/ 8 and increase every 4 wks

Question 10

Tacrine

Answer 10

Cognex

Question 11

Dosage forms of Aricept

Answer 11

Tablet and ODT

Question 12

Dose of aricept for mild to moderate disease? Dose of aricept for severe disease?

Answer 12

M: 5-10 mg QHS
S: 23 mg QHS
titrated every 4wks

Question 13

Dosage forms of Exelon

Answer 13

Tablet (BID) and Patch

Question 14

How long should you leave on an Exelon Patch

Answer 14

24 hours

Question 15

Side effects of Tacrine?

Answer 15

Hepatotoxicity

Question 16

Acetylcholinesterase inhibitors with food or without?

Answer 16

Rivastigmine is with food. The others are without regards to meals

Question 17

Side effects of acetylcholinesterase inhibitors?

Answer 17

GI**, dizziness
bradycarcia w/ donepezil
GI - use ODT, donepezil at HS, use patch

Question 18

Which product should be recommended to reduce GI side effects?

Answer 18

Exelon patch or Aricept ODT

Question 19

Memantine

Answer 19

Namenda, Namenda XR

Question 20

Memantine MOA

Answer 20

Blocks NMDA, which inhibits glutamate from binding to NMDA receptors & decreases abnormal activation

Question 21

Memantine dosage forms

Answer 21

Tablet, Capsule (XR), solution

Question 22

Memantine with food or without food?

Answer 22

Take XR with food or drink, IR with or without food

Question 23

Main side effects with memantine?

Answer 23

Dizziness, GI (diarrhea) UTI, urinary retention

Question 24

Excretion of memantine?

Answer 24

Mostly excreted unchanged in the urine; do not exceed 5 mg BID if CrCl < 30 mL/min

Question 25

How often should memantine be titrated?

Answer 25

Not more than weekly

Question 26

Drugs that can worsen dementia?

Answer 26

Anticholinergics, antihistamines, antiemetics, antipsychotics, barbiturates, BZDs, skeletal muscle relaxants

Question 27

How long do you usually wait to increase dose of acetylcholinesterase inhibitors?

Answer 27

4 weeks

Question 28

How long should you wait to use the same site with the Exelon patch?

Answer 28

14 days

Question 29

Weight loss is most often associated with which acetylcholinesterase inhibitor?

Answer 29

Exelon

Question 30

What is the maximum daily dose of galantamine in patients with renal impairment?

Answer 30

16 mg/d