Dementia pharm Flashcards
anticholingerics used for dementia
Donepezil
galantamine
rivastigmine
tacrine
antimuscarinics
atropine
cholinesterase re-activators
pralidoxime
NADAR inhibitors
memantine
tertiary and uncharged AChE inhibitor
these are the types of AChE inhibitors used for dementia
they are well absorbed from all sites with CNS distribution
they are more toxic then polar quaternary carbamates
why do we use cholinesterase inhibitors for dementia
alzheimers pts have been found to have a deficiency of intact cholinergic neurons
can also be used for parkinsons associated dementia
tacrine
highly hepatotoxic, no longer used
donepezil PK and uses
CYP meta
mild-moderate AD
severe AD dementia
dementia of parkinsons and lewy body (off-label)
donepexil ADRs
GI on initiation or dose increase
urinary incontinence
vivid dreams
bradycardia and syncope
galantamine PK and uses
CYP meta
mild-moderate AD
off label: severe AD dementia, dementia of parkinsons, lewy body
galantamine ADRs
GI dizziness weight loss bradycardia and syncope depression, fatigue, somnolence
rivastigmine PK and and uses
meta by esterase hydrolysis
mild to moderate AD
severe AD dementia
parkinons and lewy body
rivastigmine ADRs
high incidence of nausea, vomiting, diarrheas
GI less affected w/transdermal
bradycardia and syncope
memantine MOA
antagonists of NMDA glutamate R
under normal phys conditions unstimulated NMDAR ion Ch is blocked by Mg
Pathologic or excessive receptor activation does not allow the Mg to return -> chronically open -> Ca influx -> apoptosis
mementine binds mg site
uses of memantine
moderate-severe AD dementia
