Alzheimers And Depression Case Drugs

Question 1

Acetylcholinesterase inhibitors

Answer 1

• Acetylcholinesterase inhibitors
• Increases levels of ACh which helps nerve cells communicate with each other
• This cancompensate for some neuronal loss.​
• Can inhibit inflammatory signalling pathways, exerting neuroprotective effects.

•Donepezil – start at 5mg and can be increased to 10mg
•Rivastigmine – start at 3mg and can be increased to 6-12mg
•Galantamine – start at 8mg increases to 16-24mg
•Memantine – start at 5mg, increasing every week by 5mg to 20mg max (contraindication drug)

Question 2

Sites of action for drugs in neurotransmission

Answer 2

Question 3

Monoamine hypothesis of depression drugs

Answer 3

Question 4

Sites for antidepressant drug action in noradrenergic and serotonergic neurotransmission in CNS

Answer 4

Question 5

Antidepressant drugs

Answer 5

Question 6

Potential mechanism of antidepressants

Answer 6

A. Pre-treatment, neurotransmitters are released at pathologically (hypothetically) low levels and exert steady‐state levels of auto-inhibitory feedback

B. Initially, antidepressants augment neuro-transmission, e.g., by preventing uptake and increasing duration of action. This leads to increased stimulation of inhibitory presynaptic autoreceptors. The net effect is to dampen the initial effect of the medication.

C. Chronic use of antidepressants leads to desensitisation of presynaptic autoreceptors. Thus, inhibition of NT synthesis and release is reduced. The net effect is enhanced postsynaptic receptor activity leading to a therapeutic response.