Dementia Pharm

Question 1

Why are acetylecholinesterase inhibitors useful in AD pts?

Answer 1

AD pts have reduced cerebral choline acetyl transferase –> decrease in acetylcholine synthesis

Question 2

What are the available acetylecholinesterase inhibitors available for AD tx? What forms are they available in?

Answer 2

1. Donepezil: qd tablet or disintegrating sublingual tablet
2. Galantamine: bid tablet or solution, or ER qd capsule
3. Rivastigmine: bid capsule or solution, or 24hr transdermal patch

Question 3

What are the CIs for cholinesterase inhibitors?

Answer 3

baseline bradycardia

cardiac conduction system disease

use with caution if given alongside drugs that induce bradycardia or alter AV nodal conduction

Question 4

What specific CIs applies to galantamine?

Answer 4

end stage kidney diseae

severe hepatic impairement

Question 5

Which acetylecholinesterase inhibitor requires adjustments for hepatic impairment and low body weight?

Answer 5

Rivastigmine

Question 6

What is donepezil indicated for?

Answer 6

mild, moderate, or severe AD

Question 7

What are the indications for galantamine?

Answer 7

mild ot moderate AD

Question 8

What are the indications for Rivastigmine?

Answer 8

mild to moderate AD
mild to moderate dementia associated with PD

Question 9

What acetylecholinesterase inhibitor can produce significant N/V?

Answer 9

Rivastigmine

Question 10

What is the MOA of memantine?

Answer 10

antagonist of NMDA Rs