Treatment of Alzheimer's Disease Flashcards Preview

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Flashcards in Treatment of Alzheimer's Disease Deck (14)
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1
Q

Cholinergic hypothesis

A

Inolved iwth learning and memory

2
Q

Ach synthesis

A

Choline and acetyl-oA synthesize to Ach by CAT

Transported across

Degraded to choline and acetate

Recylcled by uptake

3
Q

Cholinergic dysfunctio in AD

A

Damaged early

Los of nuclei that produce Ach

Also decline in nicotonic but NOT muscarinic receptor

4
Q

Effects of cholinergic agents

A

Decreased apathy, psychosis, agitation, anxiety, depression

5
Q

Tacrine

A

For mild to moderate

Reversible AchE inhibitor

Dosed 1QID

Low bioavailability

Gender bias (higher [] in females)

CYP1A2 metab

6
Q

Tacrine contra and SE and tx for overdose

A

Liver and CV dz

Diarrhea (butyrylcholinesteease)

Atropi en IV

7
Q

Donepezil compared to tacrine

A

More selective for AchE vs. Butyryl

Completely bioavailable

Single dose

Better tolerated

All stages

8
Q

Galantamime

A

For mild to mod

Both AchE inhibitor and nicotinic receptor modulator

May provide some protection

9
Q

Rivastigmine tartrate

A

Ache inhibitor
Tablets, liquid, patch

Mild to mod

Can get more serious side effects

10
Q

Excitotoxic hypothesis

A

Excitatory NT in CNS and pruning of CNS neurons by targeted neurotoxicity

11
Q

Memantine

A

Non-competitive antagonist of NMDA receptor

Binds when open to reduce glutamate release

Mod to severe

HIgh available

Some evidence it can slow

12
Q

Duration for
Donepizil
Galantamine
rivastigmine

A

2
1
1

13
Q

Tacrine other adverse effects and dosage

A

Take on empty stomach

Hepatotoxicity

14
Q

How to target low mood,irritability
Anxiety, restlessness, verbal disruptive
Hallucinations

A

Citalopram (abnormal heart rhythms)
Anxiolytics
Anti-psychotics (be careful)

Start low