AD- Memantine DI

Question 1

Memantine MoA

Answer 1

NMDA receptor antagonist

Binds to the intra-pore magnesium site in the NMDA ion receptor channel with longer dwell time and functions as an effective receptor blocker

Question 2

Memantine indications

Answer 2

moderate-severe AD

Question 3

Caution in patients with what disease states when taking memantine?

Answer 3

Seizure and CVD history

Question 4

memantine IR dosing

Answer 4

starting dose 5mg, target is 20mg

titrate up 5mg/week

any doses more than 5mg/day should be given BID

Question 5

memantine ER dosing

Answer 5

starting dose is 7mg, increase dose by 7mg to target max dose of 28mg. Wait at least 1 week in between dosage changes

Question 6

IR renal dosing for memantine

Answer 6

5mg QD, may titrate up to target dose of 5mg BID after at least 1 week of therapy and if tolerated

Question 7

ER renal dosing of memantine

Answer 7

target dose of 14mg QD

Question 8

IR to ER dose conversion of memantine

Answer 8

10mg IR = 28mg ER

Question 9

Switch from IR to ER memantine dosing

Answer 9

begin ER product the day after the last dose of the IR formulation

Question 10

memantine PK/PD

Answer 10

Max: 3-7 hours
Food has no efficacy
Half-life: 60-80 hours
Metabolism is independent of CYP enzymes
CL reduced with alkaline urine

Question 11

memantine side effects

Answer 11

overall pretty well tolerated, may have some CV side effects and agitation

Question 12

Namzaric is a combination tablet with what 2 drugs?

Answer 12

ER memantine and donepezil

Question 13

To qualify to take Namzaric, what needs to happen?

Answer 13

Stable on a 10mg dose of donepezil