Journal of Psychosocial Nursing and Mental Health Services

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Drugs to Treat Alzheimer's Disease

Abstract

Table

Table

A handy source of up-to-date information on current medications for psychiatric illnesses

Generic (Brand) NameIndicationsContraindicationsPrecautions/Adverse Effects

ACETYLCHOLINESTERASE (AChE) INHIBITORSa
Donepezil HCl (Aricept®, Aricept® ODT)Mild to moderate and severe dementia of the Alzheimer's typeHypersensitivity to donepezil HCl or to piperidine derivatives.Precautions: Asthma or obstructive pulmonary disease; cardiac conduction abnormalities; concurrent use of NSAIDs; history of ulcer disease; seizure history; bladder flow obstruction.
Adverse effects: Diarrhea, loss of appetite, nausea, vomiting, muscle cramps, insomnia, fatigue, syncope, gastrointestinal hemorrhage, headache.

Galantamine HBr (Razadyne®, Razadyne® ER [formerly named Reminyl®])Mild to moderate dementia of the Alzheimer's typeHypersensitivity to galantamine HBr or any excipients used in the formulation.Precautions: Asthma or obstructive pulmonary disease; bladder outflow obstruction; cardiac conduction disorders; increased mortality rate in mild cognitive impairment; concomitant NSAID use; seizures; moderate-severe hepatic impairment; moderate-severe renal impairment; history of ulcer disease.
Adverse effects: Weight loss, diarrhea, loss of appetite, nausea, vomiting, dizziness, headache, gastrointestinal hemorrhage, syncope.

Rivastigmine tartrate (Exelon®, Exelon® Patch)Mild to moderate (Exelon) and mild, moderate, and severe dementia (Exelon Patch) of the Alzheimer's type (Note. Exelon is also approved for mild to moderate dementia associated with Parkinson's disease.)Hypersensitivity to rivastigmine, other carbamate derivatives, or other components of the formulation.Precautions: Asthma or obstructive pulmonary disease; extrapyramidal symptoms; seizures; peptic ulcers or gastrointestinal bleeding; sick sinus syndrome or other supraventricular cardiac conduction conditions; urinary obstruction.
Adverse effects: Dizziness, diarrhea, nausea, vomiting, headache, tremor, syncope, anorexia, weight loss, gastrointestinal hemorrhage, bronchospasm.

Tacrine HCl (Cognex®)Mild to moderate dementia of the Alzheimer's typeHypersensitivity to tacrine or acridine derivatives; patients previously treated with Cognex who developed treatment-associated jaundice, a serum bilirubin >3 mg/dL, and/or those exhibiting clinical signs or symptoms of hypersensitivity (e.g., rash, fever) in association with alanine transaminase/serum glutamic-pyruvic transaminase elevations.Precautions: Asthma; concomitant NSAID use; current or a history of abnormal liver function; history of bradyarrhythmia, conduction abnormalities, or sick sinus syndrome; seizures; history of ulcer disease.
Adverse effects: Diarrhea, loss of appetite, nausea, vomiting, increased liver aminotransferase level, myalgia, ataxia, hepatotoxicity, seizure, syncope.

ERGOT ALKALOID

Ergoloid mesylates (Hydergine®)Alzheimer's disease, dementiaHypersensitivity to ergoloid mesylate, ergot, or any components; acute or chronic psychosis.Precautions: Multiple potential drug interactions.
Adverse effects: Flushing, rash, nausea, vomiting, headache, blurred vision, nasal sinus congestion, bradyarrhythmia, orthostatic hypotension.

N-METHYL-D-ASPARTATE (NMDA) RECEPTOR ANTAGONIST

Memantine HCl (Namenda®, Namenda XR ®)Moderate to severe dementia of the Alzheimer's typeHypersensitivity to memantine HCl or any excipients used in the formulation.Precautions: Genitourinary conditions that raise urine pH; moderate-severe renal impairment.
Adverse effects: Constipation, diarrhea, confusion, dizziness, headache.

NMDA RECEPTOR ANTAGONIST/AChE INHIBITORa

Memantine HCl/donepezil HCl (Namzaric®)Moderate to severe Alzheimer's disease currently stabilized on a combination of memantine and donepezilHypersensitivity to memantine HCl or any excipients used in the formulation, donepezil HCl, or piperidine derivatives.Precautions: Similar to memantine and donepezil.
Adverse effects: Similar to memantine and donepezil.

PERIPHERAL VASODILATOR

Isoxsuprine (Vasodilan®)DementiaHypersensitivity to isoxsuprine, recent arterial bleeding, heart disease.Precautions: Bleeding disorders, chest pain, glaucoma, stroke.
Adverse effects: Hypotension, tachyarrhythmia, rash, abdominal discomfort, nausea, dizziness, pulmonary edema.
Authors

10.3928/02793695-20190305-79

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