Dementia

Question 1

What neurotransmitter is thought to be deficient in Alzheimers?

Answer 1

Acetylcholine

Question 2

Give examples of acetylcholinesterase inhibitors

Answer 2

Donepezil
Galantamine
Rivastigmine

Question 3

What are common side effects of acetylcholinesterase inhibitors?

Answer 3

GI - N+V

Question 4

How does memantine work?

Answer 4

NMDA receptor antagonist that blocks the effects of pathologically elevated levels of glutamate that may lead to neuronal dysfunction

Question 5

What is the half life of donepezil?

Answer 5

70

Question 6

What is the primary mechanism of donepezil?

Answer 6

AChE-I - selective and reversible

Question 7

What is the primary mechanism of rivastigmine?

Answer 7

AChE-I - reversible and non-competitive

Question 8

What is the half life of rivastigmine?

Answer 8

1 hour orally
3.4 hours patchy

Question 9

What is primary mechanism of galantamine

Answer 9

AChE-I - competitive and reversible

Enhances the intrinsic action of acetylcholine on nicotinic receptors, probably through binding to an allosteric site of the receptor

Question 10

What is half life of galantamine oral and XL capsules

Answer 10

7-8 oral
8-10 capsules

Question 11

What is half life of memantine

Answer 11

60-100 hours

Question 12

What are emerging treatments of alzheimers

Answer 12

Disease modifying therapies - aducanumab and lecanemab

Question 13

How do the disease modifying therapies work?

Answer 13

Target amyloid-beta plaques

Activate microglia with phagocytosis if fibrillar amyloid-beta and degradation through the endosomal/lysosomal system