Donepezil (Aricept) Flashcards

Study Notes

Donepezil Overview

Therapeutic Class: Alzheimer's disease drug
Pharmacologic Class: Cholinesterase inhibitor

Actions and Uses

Donepezil improves memory in mild to moderate Alzheimer's dementia.
Functions as an AChE inhibitor, enhancing acetylcholine effects in intact neurons.
Assess maximum benefits after at least 6 months of pharmacotherapy.
Early memory improvement may occur within 1 to 4 weeks.
Therapeutic effects are often modest and short-lived.
Advantageous long half-life allows for once-daily administration.

Administration Alerts

Administer medication before bedtime for optimal effectiveness.
Maintain a regular dosing schedule.
Classified as pregnancy category C.

Pharmacokinetics

Onset of action: less than 20 minutes.
Peak plasma concentration occurs in 3 to 4 hours.
Duration of effects varies significantly.

Adverse Effects

Common side effects include vomiting and diarrhea.
Less common: abnormal dreams, fainting, dark urine.
CNS effects may involve insomnia, syncope, depression, headache, irritability.
Musculoskeletal issues may lead to muscle cramps, arthritis, fractures.
General side effects include headache, fatigue, chest pain, increased libido, hot flashes, urinary incontinence, dehydration, and blurred vision.
No hepatotoxicity has been reported.
Monitor patients with bradycardia, hypotension, asthma, hyperthyroidism, or active peptic ulcer disease carefully.

Contraindications

Contraindicated for patients with gastrointestinal bleeding and jaundice.

Drug-Drug Interactions

Anticholinergic drugs will be less effective when used with donepezil.
Synergistic effect with bethanechol; caution advised.
Phenobarbital, phenytoin, dexamethasone, and rifampin can speed donepezil elimination.
Quinidine and ketoconazole may inhibit donepezil metabolism.
Other cholinergic drugs should not be used concurrently.

Treatment of Overdose

Anticholinergics like atropine are used as an antidote for donepezil overdose.
Initial recommended IV dose of atropine sulfate is 1 to 2 mg, with subsequent doses based on clinical response.

Other Drugs in Class

Alternatives include galantamine (Razadyne) and rivastigmine (Exelon).

Description

Explore the key concepts surrounding Donepezil, also known as Aricept, which is used in the treatment of Alzheimer's disease. These flashcards cover its therapeutic and pharmacologic classes, as well as its actions and uses in aiding memory enhancement. Perfect for students and professionals studying neurology or pharmacology.