Neuro: Pharmacology for Dementia

Question 1

MOA of donepezil

Answer 1

Acetocholinestase inhibitor

Question 2

When would you prescribe donepezil, rivastigmine, or galantamine?

Answer 2

Alzheimer’s

Question 3

Adverse effects of donepezil

Answer 3

Alter cardiac conduction (QT prolongation)
Nausea, vomiting, diarrhea

Can worsen peptic ulcer, asthma/COPD, and bladder outflow obstruction

Question 4

Can you stop donepezil without tapering?

Answer 4

No!

-can cause changing mood, crying, agitation

Question 5

Which AchE Inhibitor is a transdermal patch?

Answer 5

rivastigmine

Question 6

MOA of Memantine

Answer 6

NMDA receptor antagonist

-decreases excitability

Question 7

Clinical application of memantine

Answer 7

Alzheimer disease w/ or w/o AchE Inhibitors

Question 8

Can you stop memantine without tapering?

Answer 8

No, avoid

Question 9

Adverse effects of memantine

Answer 9

Confusion, headache, dizziness

Severe skin hypersensitivity

Question 10

What is first line treatment for Alzheimer’s?

Answer 10

AchE Inhibitors (donepezil, rivastigmine, galantamine)

Add memantine if needed