rivastigmine

Question 1

what is licensed in mild to moderate dementia in Parkinsons disease

Answer 1

rivastigmine caps or oral solution

Question 2

what is the MOA and drug class of rivastigmine

Answer 2

Ach-esterase inhibitor
a reversible non-competitive inhibitor of Achesterase

Question 3

which product is not licensed for Parkinson’s disease dementia

Answer 3

patches

Question 4

if treatment with rivastigmine PATCHES is interrupted for more than 3 days , what do you do?

Answer 4

need to re titrate from lowest strength patch (4.6mg/24h).

Question 5

if treatment with rivastigmine by mouth is interrupted for more than several days, what do you do

Answer 5

re titrate from 1.5mg BD .

Question 6

cautions

Answer 6

• asthma
• copd
• peptic, duodenal, gastric ulcers
• bladder outflow obstruction
• sick sinus syndrome
• susceptibility to ulcers

Question 7

interactions - increased risk of bradycardia with

Answer 7

• BB
• anti-arrhtyhmics
• digoxin

Question 8

what to do if pt is dehydrated from prolonged vomiting or diarrhoea

Answer 8

withhold until resolution and retitrate dose if necessary (if more than 3 days for patches, and more than several days for oral)

Question 9

monitoring requirements for rivastigmine

Answer 9

body weight

Question 10

directions for transdermal use

Answer 10

apply to clean, dry, non hairy, non irritated skin on back, upper arm, or chest
site replacement patch on a different area - avoid using same area for 14 days

Question 11

what are common SE with oral use

Answer 11

• confusion
• gait abnormal
• hallucinations
• hyperhidrosis
• hypersalivarion
• malaise
• parkinonism
• sleep disorders