Dementia Drugs (Wolff)

Question 1

What are the 3 acetylcholinesterase inhibitors used in dementia treatment?

Answer 1

**donepezil (oral)
rivastigmine (patch)
galantamine

Question 2

What is the NMDA partial agonist/antagonist used in dementia treatment?

Answer 2

Mementine

Question 3

What is the beta-amyloid monoclonal antibody used in dementia treatment?

Answer 3

aducanumab

Question 4

donepezil

Answer 4

reversibly noncompetitive inhibitor of acetylcholinestase used to treat mild to moderate Alzheimer dementia; increase acetylcholine available; no evidence that improves long-term outcomes

Question 5

Toxicities of donepezil

Answer 5

altered cardiac conduction; n/v and diarrhea; abrupt discontinuation - rapidly changing mood, easily crying and agitation; can worsen peptic ulcer

Question 6

Why are you cautioned against abrupt discontinuation of donepezil?

Answer 6

can cause rapidly changing mood, easily crying, agitation, trouble sleeping, intense hallucination and difficulty concentrating

Question 7

rivastigmine

Answer 7

acetylcholinesterase inhibitor used in dementia treatment; 24hr hour transdermal patch

Question 8

24hr hour transdermal patch used to treat dementia?

Answer 8

rivastigmine; acetylcholinesterase inhibitor

Question 9

memantine

Answer 9

NMDA partial agonis/antagonist; excess glutamate is thought to contribute to Alzheimer’s progression - this binds to the Mg site in the NMDA receptor with great affinity; has modest benefits

Question 10

Why are you cautioned against abrupt discontinuation of memantine?

Answer 10

can cause altered mental status

Question 11

Toxicities of memantine?

Answer 11

confusion, dizziness, headache, rare skin hypersensitivity and abrupt discontination can cause altered mental status

Question 12

aducanumab

Answer 12

monoclonal antibody against amyloid beta; reduces amyloid beta plaques; given IV; toxicities include - amyloid-related imagining abnormalities