Dementia Drugs Flashcards

1
Q

Cholinesterase Inhibitors

A
  1. Donepezil
  2. Rivastigmine
  3. Galantamine
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2
Q

Donepezil formulation

A

23 mg Tablet (Aricept)
10 mg Tablet
5 mg Tablet

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3
Q

Donepezil dosing

A

Mild AD and other dementias:
5 mg QD → 10 mg QD

Moderate AD: 5 mg QD → 10 mg QD → 23 mg QD

Titrate after 4 to 6 weeks, then up to 23 mg if stable on 10 mg

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4
Q

Rivastigmine formulation

A

Capsules: 1.5 mg, 3 mg, 4.5 mg, 6 mg

Patches: 4.6 mg/24 h, 9.5 mg/24 h, 13.3 mg/24 h

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5
Q

Rivastigmine dosing and route

A

Alzheimer’s, PD dementia:
PO 1.5 mg BD → 3 mg QD (Titrate every 2 weeks, maximum 6 mg BD)
Transdermal 4.6 mg QD → 9.5 mg QD → 13.3 mg (Titrate every 4 weeks)

Oral form for vascular dementia, dementia with Lewy bodies

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6
Q

Galantamine formulation

A

PR Capsules: 8 mg, 16 mg, 24 mg

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7
Q

Galantamine dosing

A

Range: 16 to 24 mg QD (If therapy is interrupted for ≥3 days, restart at the lowest dose and increase to current dose)

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8
Q

AChE Inhibitor Monitoring Parameters

A

ECG (QTc): Risk factors in older adults, CVD, stroke

BP/HR

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9
Q

ADRs for AChE inhibitors

A
  1. NVD (Cholinergic effect)
  2. Drowsiness
  3. Difficulty sleeping (Patch)
  4. Skin irritation (Patch)
  5. Weight loss, reduced appetite (Dose-related cholinergic activity that increases smooth muscle contraction)
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10
Q

NMDA Antagonist

A

Memantine

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11
Q

Indications of memantine

A

Alzheimer’s Disease
Dementia
Neurocognitive toxicity of whole brain irradiation (Prevention)
Skin picking disorder

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12
Q

Memantine formulation and dosing

A

10 mg Tablets

Initial doses: 5mg/day, titrate every week (Can be once daily or 2 divided doses)

Maximum dose: 20 mg/day

CrCL < 50 mL/min: 5 mg QD, titrate at least 1 week of therapy, to 5 mg BD

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13
Q

ADRs of memantine to monitor

A

Neuropsychiatric effects:
- Common: confusion, dizziness, drowsiness, and headache
- Others: Loss of consciousness, sleep disturbance, seizures
- Rare: Agitation, delusion, hallucination

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14
Q
A
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