Acetylcholinesterase inhibitors Flashcards
1
Q
What are the generic and brand names of Acetylcholinesterase inhibitors?
A
- Donepezil (Aricept)
* Rivastigmine
2
Q
What is the method of action of Acetylcholinesterase inhibitors?
A
- Specific and reversible inhibitor of acetylcholinesterase
- ↑ Ach in the synapse
- = more synapsing
- = makes up for the neurons of the brain that are damaged
3
Q
What are the indications for Acetylcholinesterase inhibitors?
A
• Mild to moderately severe Alzheimer’s dementia
4
Q
What are the contraindications for Acetylcholinesterase inhibitors?
A
- Supraventricular diseases e.g. Sick sinus syndrome, AVT block
- Heart block/sinusal pauses - ↑ risk of seizures/syncope
- ↑ risk of peptic ulcers
- Hepatic problems – use with caution in those with mild to moderate liver disease
- Difficulty passing using/kidney disease
- Asthma/COPD
- Extrapyramidal symptoms – may exacerbate these symptoms
- Children/adolescents
- Breastfeeding
5
Q
What are the side effects of Acetylcholinesterase inhibitors?
A
- Diarrhoea
- Muscle cramps
- Fatigue
- Nausea/Vomiting
- Insomnia
- Headache
- Common cold
- Syncope/dizziness
- Urinary incontinence
- Hallucinations
- Common cold
- Bradycardia
- Seizures
- Neuroleptic malignant syndrome
6
Q
What are the interactions with Acetylcholinesterase inhibitors?
A
- NSAIDs
- Ketoconazole/Itraconazole - ↓ metabolism of donepezil
- Quinidine - ↓ metabolism of donepezil
- Erythromycin - ↓ metabolism of donepezil
- Fluoxetine - ↓ metabolism of donepezil
- Rifampicin - ↓ metabolism of donepezil
- Phenytoin - ↓ metabolism of donepezil
- Carbamazepine - ↓ metabolism of donepezil
- Alcohol - ↓ metabolism of donepezil
- Succinylcholine-type muscle relaxation - ↑ effect during anaesthesia
7
Q
What organ eliminates Acetylcholinesterase inhibitors?
A
Kidney
