Alzheimer's

Question 1

AChE inhibitors? Which one is now withdrawn and obsolete? These are used mostly for what phase of dementia? Except?

Answer 1

Tacrine (w/drawn & obsolete), Donepezil, Rivastigmine, Galantamine. Used best for mild-moderate Alzheimer’s, except Donepezil: Approved for mild-moderate & severe .

Question 2

The non-AChE inhibitor Alzheimer’s drug?

Answer 2

Memantine – Partial antagonist of NMDA receptor

Question 3

Memantine is best for?

Answer 3

Severe Alzheimer’s

Question 4

Side effects of Memantine?

Answer 4

Dizziness, Confusion, HA, Constipation

Question 5

Side effects of AChE inhibitors?

Answer 5

N/V, sleep disturbances (SLUDGE!) – Tacrine also elevated transaminases and caused D w/ abdominal cramping

Question 6

Tacrine was metabolized by? Had to be taken?

Answer 6

P450. 4X/day.

Question 7

Donepezil is metabolized by? Has to be taken?

Answer 7

P450. 1X/day.

Question 8

Rivastigmine is metabolized by? Has to be taken?

Answer 8

Cholineterases. 2X/day.

Question 9

Galantamine is metabolized by? Has to be taken?

Answer 9

P450. 2X/day, 1X/day for ER strength.

Question 10

Memantine is metabolized by? Has to be taken?

Answer 10

Excreted unchanged in the urine. Dosed 2X/day.

Question 11

Only AChE inhibitor approved for treatment of mild-moderate dementia in Parkinson’s?

Answer 11

Rivastigmine

Question 12

Only AChE inhibitor available in a transdermal formulation?

Answer 12

Rivastigmine