AzD Meds

Question 1

What are the 2 types of meds used for AD?

Answer 1

• cholinesterase inhibitors

- N-methyl-D-aspartate (NMDA) receptor agonists

Question 2

What are the 2 drugs that are cholinesterase inhibitors?

Answer 2

• Donepezil (aricept)

- Rivastigmine (Exelon)

Question 3

What drugs is the NMDA receptor agonist?

Answer 3

Memantine (Namenda)

Question 4

What drugs can be used for depression in pt’s with AD?

Answer 4

SSRI’s:

• Fluoxetine (Prozac)
• Mirtazapine (Remeron)

Question 5

What drugs can be used for behavior problems in pt’s with AD?

Answer 5

Antipsychotics: 
-Aripiprazole (Abilify) 
-Olanzapine (Zyprexa) 
Benzodiazapines 
-Lorazepam

Question 6

What does cholinesterase inhibitors do and and stage of AD does it treat?

Answer 6

• prevents breakdown of acetylcholine, increasing bioavailability
• may help to slow progression of disease
• mild to moderate disease

Question 7

What are the side effects of cholinesterase inhibitors?

Answer 7

bradycardia
wheezing
diaphoresis
miosis
diarrhea
salivation
GI: n/v, dyspepsia, diarrhea
dizziness
headache

Question 8

What are the drug interactions causing reduced therapeutic effects for cholinesterase inhibitors?

Answer 8

• anticholinergic agents
• 1st gen antihistamines
• tricyclic antidepressants
• conventional antipsychotics

Question 9

What level of AD is donepezil (aricept) indicated for?

Answer 9

mild, moderate, or severe

Question 10

This causes reversible inhibition of cholinesterase.

Answer 10

donepezil (aricept)

Question 11

How often are the doses increased for donepezil (aricept) to decrease AE?

Answer 11

Q 1-3 months

Question 12

What is one big difference between donepezil (aricept) and rivastigmine (exelon)?

Answer 12

• donepezil (aricept): causes reversible inhibition of cholinesterase.
• rivastigmine (exelon): irreversible inhibition of cholinesterase

Question 13

What are the side effects of rivastigmine (exelon)?

Answer 13

• N/V, diarrhea, abd pain, anorexia, significant weight loss
• intensify symptoms in pt’s with peptic ulcer disease, bradycardia, sick sinus syndrome, fall related fractures

Question 14

What is the NMDA receptor agonist Memantine (Namenda) indicated for?

Answer 14

• moderate to sever AD

- better tolerated than cholinesterase inhibitors

Question 15

What are the side effects and drug interactions for the NMDA receptor agonist Memantine (Namenda)?

Answer 15

• dizziness, headache, confusion, constipation

- amentadine, ketamine, sodium bicarbonate

Question 16

What are the mechanisms of action for Memantine (Namenda)?

Answer 16

• glutamate at NMDA receptors is used in synapses in learning and memory
• displaced magnesium to allow calcium entry. Calcium entry is the signal in learning and memory