Pharm: Dementia - Iszard Flashcards
what are the only currently available symptomatic medications for cognition and global functioning in pateitns with dementia?
cholinesterase inhibitors and memantine
why are AChE-I’s considered symptomatic therapies and are not believed to be neuroprotective or to alter the underlying disease trajectory?
they target the ACh defecit arising from loss of neurons in the nucleus basalis of Meynert
what should newly diagnosed AD pts be offered a trial of?
AChE-I for symptomatic treatment of cognition and global functioning
donepezil
AChE-I
- ONCE-daily tablet, ONCE-daily disintegrating sublingual tablet
galantamine
AChE-I
- TWICE-daily tablet or solution, and XR capsule
rivastigmine
AChE-I
- 24-hr transdermal patch
- or TWICE-daily capsule/TWICE-daily solution
what is galantamine contraindicated?
pts with ESRD or severe hepatic impairment
when does rivastigmine patch require dose adjustment?
for hepatic impairment and low body weight
what should AChE-I’s be used with caution?
when used in combination with drugs that induce bradycardia or alter AV nodal conduction
when are AChE-I’s contraindicated?
pts with baseline bradycardia or known cardiac conduction system disease
AChE-I indicated for tx of Alzheimer’s dementia (mild, moderate, and severe)
- preferred and widely prescribed drug
donepezil
what are contraindications of donepezil?
pts w/ known hypersensitivity to donepezil HCl or piperidine derivatives
NOTE: may also have vagotonic effects on SA and AV nodes (BRADYCARDIA)
what are adverse reactions to donepezil?
N/V/D, insomnia, muscle cramps, fatigue, anorexia
AChE-I indicated for tx of mild-moderate Alzheimer’s dementia
galantamine
what are the contraindications of galantamine?
known hypersensitivity to galantamine HBr
