AlzheimersFC Flashcards
What is the most common type of dementia?
Alzheimer’s Disease
What is an indication of impairment on the Mini-Mental State Exam?
<24
What is the mainstay of therapy for AD?
Acetylcholinesterase inhibitors, such as donepezil
natural products being used to treat dementia?
Vitamin E, Ginko, and Huperzine A, A-phosphaticylserine, acetyl-L-carnitine
Main side effect you are worried about with Ginko?
Increases bleeding risk
Drug interactions with acetylcholinesterase inhibitors?
Anti-muscarinic agents used for overactive bladder; can decrease efficacy of the dementia drug
Donepezil
Aricept, Aricept ODT, Aricept high dose
Rivastigmine
Exelon, Exelon Patch
Galantamine
name
dose
Razadyne: 4-12 BID
Razadyne ER: 8 - 24 QD, start w/ 8 and increase every 4 wks
Tacrine
Cognex
Dosage forms of Aricept
Tablet and ODT
Dose of aricept for mild to moderate disease? Dose of aricept for severe disease?
M: 5-10 mg QHS
S: 23 mg QHS
titrated every 4wks
Dosage forms of Exelon
Tablet (BID) and Patch
How long should you leave on an Exelon Patch
24 hours
Side effects of Tacrine?
Hepatotoxicity
Acetylcholinesterase inhibitors with food or without?
Rivastigmine is with food. The others are without regards to meals
Side effects of acetylcholinesterase inhibitors?
GI**, dizziness
bradycarcia w/ donepezil
GI - use ODT, donepezil at HS, use patch
Which product should be recommended to reduce GI side effects?
Exelon patch or Aricept ODT
Memantine
Namenda, Namenda XR
Memantine MOA
Blocks NMDA, which inhibits glutamate from binding to NMDA receptors & decreases abnormal activation
Memantine dosage forms
Tablet, Capsule (XR), solution
Memantine with food or without food?
Take XR with food or drink, IR with or without food
Main side effects with memantine?
Dizziness, GI (diarrhea) UTI, urinary retention
Excretion of memantine?
Mostly excreted unchanged in the urine; do not exceed 5 mg BID if CrCl < 30 mL/min
How often should memantine be titrated?
Not more than weekly
Drugs that can worsen dementia?
Anticholinergics, antihistamines, antiemetics, antipsychotics, barbiturates, BZDs, skeletal muscle relaxants
How long do you usually wait to increase dose of acetylcholinesterase inhibitors?
4 weeks
How long should you wait to use the same site with the Exelon patch?
14 days
Weight loss is most often associated with which acetylcholinesterase inhibitor?
Exelon
What is the maximum daily dose of galantamine in patients with renal impairment?
16 mg/d
