13 - B) ALZHEIMER DISEASE

Question 1

DRUGS USED IN AD

Answer 1

Nowadays, there is no cure for AD, so the objetctives of its therapy are to attenuate the symptoms and to slow down the cognitive and functional impairment. The drugs used have the aim of restoring deficiencies in two NT systems; cholinergic and glutamate system.

Question 2

Drugs acting in the cholinergic system (characteristics)

Answer 2

Remember than in AZ, ther is a loss of Nt, specially; acetylcholine. The drugs employed in this case are AChE inhibitors. In AD we need thise which are able to cross the BBB and to act on the CNS.

Question 3

Name of drugs which are used in the AD (Cholinergic system)

Answer 3

Tacrine
Donezepil
Glantamine
RIvastigmine

Question 4

Side effects of drugs (cholinergic system)

Answer 4

Digestive effects; nausea, vomiting

Others; anorexia and weight loss, myasthenia, respiratory depression and bradycardia

Question 5

Drugs acting on the glutamate system

Answer 5

The main one is Memantine, NMDA receptor antagonist

It does not blind to the glutamate site, but t the Mg+2 site of the channel. It decreases the activation of the channel by glutamate.
It preents enterotoxicity without affecting physiological glutamatergic activity.

Question 6

Side effects of drugs acting on the glutamate system

Answer 6

Digestive; nausea, vomits and diarrhea

Others; dizziness, fatigue, confusion, hallucinations.

Question 7

Management of AD (First stege)

Answer 7

Depression and anxiety.

Antidepressants; ISRS,
Mirtazapine

Question 8

Management of AD (Second stege)

Answer 8

Antiepileptics; Gabapentin Carbamazepine and Valproate

Question 9

Management of AD (Third stage )

Answer 9

Antipsychotics; Risperidone and Olanzapine

Question 10

Tacrine

Answer 10

a

Question 11

Donezepil

Answer 11

b

Question 12

Galantamine

Answer 12

c

Question 13

Rivastigmine

Answer 13

d