CNS PART 2.docx

[CNS PART 2] ALZHEIMER'S DISEASE Neuronal degeneration in the hippocampus (early) and cerebral cortex (later). Acetylcholine loss! Neurotic plaques (beta-amyloid) is hallmark of AD. Also Tau tangles! APOE4 gene. Eat foods rich in folic acid! Goal: to improve the symptoms and reverse the cognitiv...

[CNS PART 2] ALZHEIMER'S DISEASE Neuronal degeneration in the hippocampus (early) and cerebral cortex (later). Acetylcholine loss! Neurotic plaques (beta-amyloid) is hallmark of AD. Also Tau tangles! APOE4 gene. Eat foods rich in folic acid! Goal: to improve the symptoms and reverse the cognitive decline. - Cholinesterase inhibitors (donepezil, galantamine, and rivastigmine) - AE: GI, dizziness, headache, bronchoconstriction, and symptomatic brady - Avoid anti-psychotics and tricyclic anti-depressants - Donepezile: CYP substrate, causes reversible inhibition of acetylcholinesterase Highly protein bound, long halflife, takes 15 days to reach a steady state. - Rivastigmine: Causes IRRIVERSIBLE inhibition of acetylcholinesterase - Galantamine is from daffodil bulbs! Same as above - Memantine - for mod-severe AD. Can take with Donepezil for added benefits. - It modulates the effects of glutamate. - AE: dizziness, headache, confusion - Dosage requirements for pts w/ creatinine clearance \