CNS System

Question 1

donepezil

Answer 1

Alzheimer’s disease

Cholinesterase inhibitors: increase the concentration of acetylcholine

Question 2

Rivastigmine

Answer 2

Treat dementia

Cholinesterase inhibitor

Question 3

Galantamine

Answer 3

Treat mild to moderate dementia

-inhibitor of acetylcholinesterase

Question 4

Memantine

Answer 4

Alzheimer’s disease

-is an antagonist of the NMDA: receptor subtype of glutamate receptor

Question 5

Rivastigmine
ri-va-STIG-meen (Exelon)
–Alzheimer’s disease

Cholinesterase inhibitors

Answer 5

Anti-Alzheimer drug
-Mild to moderate dementia form Alzheimer disease.

• Enhances cholinergic function by increasing the concentration of Ach
• Dose not alter the course of underlying dementing process

CNS: headache, dizziness, syncope, fatigue, asthenia, malaise, somnolence, tremor, insomnia, confusion, depression, anxiety, hallucination, aggressive reaction, vertigo.

• CV: HTN, chest pain, peripheral edema.
• EENT: rhinitis, pharyngitis.
• GI:N, V, D, anorexia, abdominal pain, dyspepsia, constipation, flatulence, eructation ( burping or belching), GI bleeding.
• GU: UTI, incontinence.
• Metabolic: weight loss.
• Musculoskeletal: bradykinesia, dyskinesia, hypokinesia, weakness.
• Respiratory: URI, cough, bronchitis.
• Skin: increased sweating, rash.

Question 6

Carbidopa-levodopa
(Sinemet)

• -Parkinson’s disease
• -A syndrome due to 3 major features:
• Bradykinesia (slow movement
• Rigidity ( abnormal increased muscles tone)
• Tremors
• Imbalance between dopamine (inhibitory neurotransmitter) & acetylcholine (excitatory neutrotransmitter)
• unexplained degeneration of dopaminergic neurons

*pseudoparkinsonism: occur form an adverse reaction to antipsychotics.
s/s:
Decarboxylase inhibitors-dopamine precursors

Answer 6

Treat Parkinson’s disease
-relieve tremors and rigidity.

Transmission of levodopa to brain cells for conversion to dopamine—allow more levodopa to reach the brain

CNS: syncope, agitation, bradykinetic episodes, confusion, dementia, suicidal tendencies, dizziness, depression, headache, insomnia, NMS, paresthesia.

• CV: cardiac irregularities, HTN, hypotension, orthostatic hypotension, palpitations, phlebitis, MI.
• GI: anorexia, constipation, dark saliva, D, V, dry mouth, dyspepsia, GI bleeding.
• GU: dark urine, urinary frequency, UTI
• Hematologic: agranulocytosis, hemolytic and nonhemolytic anemia, leukopenia, thrombocytopenia.
• Musculoskeletal: back pain, muscles cramps, shoulder pain.
• Respiratory: dyspnea, URI.
• Skin: alopecia, rash, diaphoresis, dark sweat.