Alzheimer's Disease

Question 1

what meds worsen memory loss

Answer 1

antiemetics (promethazine)
AHs
APs
barbiturates
benzos
benztropine
skeletal muscle relaxants
opioids
sedative hypnotics

Question 2

non pharm for dementia

Answer 2

d/c offending medications
exercise
dietary adjustments
BG, BP, cholesterol management
brain-stimulating activities

Question 3

first line for mild-moderate alzheimers

Answer 3

AchE inhibitors
- donepezil
- rivastigmine
- galantamne

Question 4

first line for moderate-severe alzheimers

Answer 4

AchE inhibitor +/- memantine

Question 5

what is the brand name for donepezil/memantine? when can a patient be switched to this?

Answer 5

Namzaric
once stabilized on 10mg donepezil

Question 6

donepezil
brand name
dosing
warnings

Answer 6

Aricept
5mg PO HS x4-6 weeks then can increase to 10mg PO HS
after 3 months can inc to 23mg PO HS

warnings: QT prolongation, bradycardia, syncope, weight loss/anorexia

taken at night to avoid nausea

Question 7

what population should donepezil especially be used with caution in

Answer 7

patients <55kg

Question 8

rivastigmine
brand name
dosing
MDD

Answer 8

Exelon patch and capsule
capsule: 1.5mg BID inc q2weeks to 6mg BID
patch: inc dose q4weeks
MDD hepatic impairment is 4.6mg for patch!

Question 9

memantine
brand name
dosing
SE

Answer 9

Namenda
IR: 5mg PO QD inc qweek to 10mg PO BID
ER: 7mg PO QD, inc qweek to 28mg PO QD

SE: dizziness, confusion, HA