Week 10: Alzheimer's disease drugs

Question 1

Alzheimer’s disease

protect what?
Block what?

Answer 1

1. Protect acetylcholine
2. Block Glutamate

Question 2

Centrally acting Acetylcholinesterase Inhibitor/Anti-cholinesterase

DONEPEZIL
RIVASTIGMINE

USED TO TREAT?

Answer 2

Alzheimer Disease

Other Dementias

Question 3

DONEPEZIL
RIVASTIGMINE

Adverse effects?
GI?
Neuro?
Lung concerns?
CV?

Answer 3

GI symptoms:
N/V
Dyspepsia
Diarrhea

Dizziness + Headache (fall risk)

Lung: Bronchoconstriction (caution in COPD/Asthma)

Cardiovascular: Symptomatic bradycardia, QT prolongation

Question 4

DONEPEZIL
RIVASTIGMINE

More Adverse effects?

Answer 4

SLUDGE’M and the Killer B’s!

Salivation
Lacrimation
Urination
Defecation
GI symptoms (N/V)
Emesis
Miosis

The Killer B’s (Bradycardia, Bronchorrhea, Bronchospasm)

Question 5

DONEPEZIL, RIVASTIGMINE

Administration?

Donepezil PO give when?
Rivastigmine give how?
transdermal?

Answer 5

Donepezil PO: Give at bedtime

Notable GI effects and dizziness….. Sleep through them?

Rivastigmine:
-PO: give with food to minimize GI A/E
-Transdermal: Apply every 24 hours

Question 6

MEMANTINE

USED TO TREAT?
Brand name?
Antagonist at what receptor?

Answer 6

WELL TOLERATED

Moderate to Severe Alzheimer Disease

Other Dementias

Brand name is NAMENDA
NMDA receptor