Pharmacology for Dementia Flashcards
(14 cards)
What is the pharmacology behind dementia?
Patients with Alzheimer’s Disease (AD) have reduced cerebral content of choline acetyltransferase, which leads to a decrease in acetylcholine synthesis and impaired cortical cholinergic function
What is the MOA of cholinesterase inhibitors?
Increase cholinergic transmission by inhibiting cholinesterase at the synaptic cleft
Should we continue to give patients with AD cholinesterase inhibitors?
No
Therapy should not be continued indefinitely in patients who do not appear to be benefiting or who have significant side effects
What are the three choices of drugs for the treatment of AD?
Donepezil
Galantamine
Rivastigmine
Why are cholinesterase inhibitors contraindicated in patients with certain heart diseases?
They enhance vagal and are thus contraindicated in patients with baseline bradycardia or known conduction system disease
What are some contraindications of Rivastigmine and Galantamine?
Galantamine: Should not be used in patients with end-stage kidney disease or severe hepatic impairment
Rivastigmine: the patch requires dose adjustments for hepatic impairment and low body weights
What is the indication for Donepezil?
Donepezil is an acetylcholinesterase inhibitor indicated for the treatment of dementia of the Alzheimer’s type
What are some warnings regarding Donepezil?
May have vagotonic effects on the sinoatrial and atrioventricular nodes manifesting as bradycardia and heart block
What is the indication for Galantamine?
Galantamine is a cholinesterase inhibitor indicated for the treatment of mild to moderate dementia of the Alzheimer’s type
What is an indication for Rivastigmine?
Along with treating Alzheimer’s related dementia, Rivastigmine can also be used for mild to moderate dementia associated with Parkinson’s disease
How is Rivastigmine delivered?
Rivastigmine is a transdermal patch system
What must be monitored during therapy with Rivastigmine?
Weight
What is the purpose of Pralidoxime
It is a cholinesterase regenerator
capable of regenerating active AChE enzyme by removal of the phosphorous group from the active site of the enzyme
What is the MOA of Memantine?
antagonist of the NMDA type of glutamate receptors
