Drugs for Dementia

Question 1

What is the MOA of donepezil?

Answer 1

reversibly and noncompetitively inhibits centrally active acetylcholine esterase

Question 2

What is the MOA of memantine?

Answer 2

NMDA receptor antagonist

Question 3

What conditions can the use of donepezil worsen?

Answer 3

peptic ulcer
asthma/COPD
bladder outflow obstruction

Question 4

What is contraindicated in the use of both donepezil and memantine?

What does it lead to?

Answer 4

1) abrupt discontinuation

2) It can lead to mood changes, agitation, hallucinations, anxiety, etc.

Question 5

What toxicities are unique to donepezil?

Answer 5

Altered cardiac conduction

weight loss/anorexia secondary to nausea, vomiting, diarrhea

Question 6

What is a reversible AChE inhibitor for dementia that offers a transdermal patch option?

Answer 6

rivastigmine

Question 7

What toxicities are unique to memantine?

Answer 7

confusion, dizziness, headache

severe skin hypersensitivity reactions

Question 8

What is the clinical application of memantine

Answer 8

For moderate to severe alzheimers, in monotherapy or in combination with a cholinesterase inhibitor

Question 9

What SSRI is often used for treatment of depression in Alzheimer disease

Answer 9

Citolapram

Question 10

What can be used in the treatment of apathy

Answer 10

A cholinesterase inhibitor
A therapeutic trial of an antidepressant
Low dose methylphenidate

Question 11

What treatment strategy is used for sleep disturbances?

Answer 11

nonpharmacologic, like maintaining good sleep hygiene, exercise, etc.