Alzheimer's

Question 1

Donepezil (Aricept)

Answer 1

A) Anticholinesterase OR Acetylcholinesterase Inhibitor

B)
1. Alzheimer’s disease

C)
5 - 10 mg ONCE daily

D)

1. Drugs with Anticholinergic effects (antagonises effect)
2. Treatment interruption (restart at initial dose)
3. Clinical improvement (trial period 6 months)
4. Duration of treatment
5. Bradycardia (infrequent - precaution)

E)
Labels: 12, 16
#Take at the SAME TIME each day - preferably at BEDTIME.
#If you experience VIVID DREAMS at night - take in the morning
S/E:
*CNS (headache, insomnia, vivid dreams, depression, fatigue, drowsiness, dizziness)
*GIT (n+v, diarrhoea, anorexia, abdo pain, weight loss, urinary incontinence)

Question 2

Galantamine (Reminyl)

Answer 2

A) Anticholinesterase OR Cholinesterase Inhibitor

B)
1. Mild-to-Moderate Alzheimer’s disease

C)
8 - 24 mg ONCE daily

D)

1. Drugs with Anticholinergic effects (antagonises effect)
2. Treatment interruption (restart at initial dose)
3. Clinical improvement (trial period 6 months)
4. Duration of treatment
5. Bradycardia (infrequent - precaution)
6. DRUG INTERACTIONS (CYP 2D6, 3A4)
7. RENAL ** (contraindiated <10mL/min)
8. HEPATIC ** (reduced dose)

E)
Labels: 5, 12, A*, B (WITH FOOD)
#Take preferably in the morning
S/E:
*CNS (headache, insomnia, vivid dreams, depression, fatigue, drowsiness, dizziness)
*GIT (n+v, diarrhoea, anorexia, abdo pain, weight loss, urinary incontinence)

Question 3

Rivastigmine (Exelon)

Answer 3

A) Anticholinesterase

B)
1. Alzheimer’s disease

C)

• ORAL: 1.5 - 6 mg TWICE daily
• PATCH: 1 patch (4.6 mg/24hrs) - 1 patch (9.5 mg/24hrs) ONCE daily

D)
1. Drugs with Anticholinergic effects (antagonises effect)
2. Treatment interruption (restart at initial dose)
3. Clinical improvement (trial period 6 months)
4. Duration of treatment
5. Bradycardia (infrequent - precaution)
6. HEPATIC (contraindicated)
NO renal

E)
Labels: 12, B* (caps - WITH morning & evening MEALS)
#PATCH - Apply to clean, dry, hairless skin on the BACK, UPPER ARM or CHEST. Avoid re-using same area within 2 weeks.
S/E:
*SKIN (hypersensitivity -patch)
*CNS (headache, insomnia, vivid dreams, depression, fatigue, drowsiness, dizziness)
*GIT (n+v, diarrhoea, anorexia, abdo pain, weight loss, urinary incontinence)

Question 4

Memantine (Ebixa)

Answer 4

A) NMDA Antagonist

B)
1. Moderate-to-Severe Alzheimer’s disease

C)
5 - 20 mg ONCE daily

D)
1. Treatment Interruption
2. Duration of treatment
3. Behavioural and Functional Status review
4. RENAL (reduce dose)
NO Hepatic

E)
Labels: 12+
#This medicine is usually TRIALLED for 6 MONTHS to determine its effectiveness
#The tablets should be taken at the SAME TIME each day - preferably in the morning
S/E:
*CNS (confusion, dizziness, drowsiness, headache, insomnia, agitation, hallucinations)