Pharm Ii: Alzheimers Disease And Dementia

Front 1

What are the cholinesterase inhibitors used in dementia?

Back 1

donepezil, rivastigmine, galantamine
(DON'T take me RIVER GALLON)

Front 2

donepezil: uses, half-life, SEs, metabolism

Back 2

used in mild, moderate and severe AD, other types of dementia
reversible AchE inhib
long half-life
SEs are muscarinic in nature: bradycardia, GI upset, muscle cramps, urinary incont
metab is hepatic

Front 3

rivastigmine: uses, half-life, SEs, metabolism

Back 3

used in mild/moderate dementia
non-competitive inhibitor (STIGMATIZE)
shorter 1/2 life, BID dosing
metabolized via ChE hydrolysis, no DDIs
SEs muscarinic
(METABOLIZED IN THE RIVER (BLOODSTREAM))

Front 4

galantamine

Back 4

mild-moderate AD, vascular dementia
reversible competitor of AChE
BID dosing
metabolized by CYP and excreted unchanged

Front 5

cholinesterase inhibitros: general effect on AD

Back 5

significant but modest improvements
do not slow ultimate progression of MCI --> AD
not disease modifying drugs

Front 6

memantine

Back 6

blocks NMDA receptors (when glutamate bound), uncompetitive agonist
used in moderate - severe AD, vascular dementia
Safe and well tolerated
excreted unchanged in urine, so no metabolic interactions

Front 7

What is a new anti-amyloid therapy?

Back 7

anti Abeta clearance, by passive or acvitve immunization

Front 8

which new therapy works by decreaseing Abeta generation?

Back 8

inhibiting gamma-secretase (semagacestat)
lowered amyloid production but decreased cog function

Front 9

how might methylthioninium chloride work? (methylene blue)

Back 9

disrupts tau-mediated tangle formation