Week 12: Cholinesterase Inhibitors, NMDA receptor antagonist,

Question 1

Cholinesterase Inhibitors:

Donepezil (Aricept), Rivastigmine (Exelon) MOA & Indc

Answer 1

inhibits centrally active acetylcholinesterase (AChE) = increase levels of Ach available for synaptic transmission in the CNS

indirect cholinergic agonist
(opposite of anticholinergics)

indi: Alzheimers disease

Question 2

Cholinesterase Inhibitors:
Donepezil (Aricept), Rivastigmine (Exelon)
ADE

Answer 2

opposite of anticholinergic side effects:

Dizziness, headache, agitation, falls, weight loss, nausea, vomiting, diarrhea, insomnia, tremor

Exacerbate EPS if have parkinsons

Monitor signs of toxicity, constricted pupils, excessive salivation, diarrhea
Metabolized by P450

Question 3

Cholinesterase Inhibitors:
Donepezil (Aricept), Rivastigmine (Exelon)
c/c

Answer 3

NO anticholinergics drugs
QT prolongation (donepezil)

Question 4

memantine (Namenda) class, MOA, indc

Answer 4

NMDA receptor antagonist

Alz is thought to be persistent stimulation of NMDA receptors by glutamate so this antagonizes the receptors

best for neuropsychiatric sx’s

Question 5

memantine (Namenda) ADE

Answer 5

Confusion, dizziness, constipation, headache, somnolence, hypertension, diarrhea, hypersensitivity reaction (rare)

Question 6

memantine (Namenda) c/c

Answer 6

caution in CVD, renal, seizure