Alzheimer’s

Question 1

Acetylcholinesterase Inhibitors

Mild to moderate/ mixed AD

Answer 1

• Donepezil
• Galantamine
• Rivastigmine

MOA:

Cholinergic forebrain pathways innervating limbic/cortical structures degenerates in AD. Include:
o Basal forebrain/cholinergic system
o Nucleus Basalis of Meynert
o Horizontal/Vertical Diagonal Bands of Broca
o Medial Septal Nucleus
• Inhibiting acetylcholinesterase stops breakdown of acetylcholine.
• Acetylcholine promotes healthy cognition.

Question 2

NMDA Receptor Antagonists

Moderate to Severe AD

Answer 2

• Memantine

MOA:
AD may be associated with a slow form of excitotoxicity and increased glutamate. Blocking release of glutamate help easing distressing/challenging behaviours/delusion.