Dementia medication Flashcards

1
Q

hMechanism of action of donepezil

A

Selective reversible acetylcholinesterase inhibitor

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2
Q

Mechanism of action of rivastigmine

A

Reversible non-competitive acetylcholinesterase inhibitor (pseudo-irreversible)
Butyrylcholinesterase inhibitor

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3
Q

Mechanism of action of galantamine

A

Competitive reversible acetylcholinesterase inhibitor

Binds allosterically to the nicotinic acetylcholine receptor

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4
Q

Mechanism of action of memantine

A

Non-competitive NMDA glutamate receptor antagonist

5HT3 receptor antagonist

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5
Q

Half life of donepezil

A

70 hours

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6
Q

Half life of oral rivastigmine

A

1 hour

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7
Q

Half life of patch rivastigmine

A

3.4 hours

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8
Q

Half life of galantamine

A

7-8 hours

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9
Q

Half life of prolonged release galantamine

A

8-10 hours

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10
Q

Half life of memantine

A

60-100 hours

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11
Q

Acetylcholinesterase inhibitor which is available in patch form

A

Rivastigmine

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12
Q

Acetylcholinesterase inhibitor which is available in prolonged release form

A

Galantamine

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13
Q

Most common side effects of acetylcholinesterase inhibitors

A
Diarrhoea
Nausea
Anorexia
Headache
Dizziness
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14
Q

CYP enzymes involved in the metabolism of donepezil and galantamine

A

CYP3A4

CYP2D6

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15
Q

Side effects of memantine

A
Somnolence or agitation
HTN
Dizziness
Dyspnoea
Constipation
Elevated LFTs
Headache
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16
Q

Acetylcholinesterase inhibitor which is no longer used in the UK due to reports of fatal hepatotoxicity

A

Tacrine

17
Q

Cholinergic side effects of acetylcholinesterases

A
Increased risk of GI bleeding
Bradycardia
Worsened COPD
Urinary retention
Increased seizure risk
18
Q

Acetylcholinesterase inhibitor which is selective and reversible

A

Donepezil

19
Q

Acetylcholinesterase inhibitor which is non-competitive and reversible

A

Rivastigmine

20
Q

Acetylcholinesterase inhibitor which is competitive and reversible

A

Galantamine

21
Q

Target for future antidementia drugs

A

Betasecretase enzyme

22
Q

Most common side effect of acetylcholinesterase inhibitors

A

Nausea

23
Q

Anti dementia drug which has been shown to be neuroprotective

A

Memantine

24
Q

Type of dementia where cholinesterase inhibitors should not be used

A

Frontotemporal dementia

25
Q

Reason to avoid cholinesterase inhibitors in frontotemporal dementia

A

Can worsen behavioural symptoms

26
Q

Anti amyloid monoclonal antibodies which have been tested for the treatment of Alzheimer’s dementia

A

Solanezumab

Bapineuzumab

27
Q

Antidementia medication which undergoes no hepatic conversion, and is broken down by choinesterase itself

A

Rivastigmine