Lippincotts Drugs to Know for the NCLEX

Alzheimer’s disease drugs
donepezil hydrochloride
memantine hydrochloride
rivastigmine tartrate
INDICATIONS
Treatment of mild to moderate dementia of the Alzheimer’s type
ACTION
Current theories attribute signs and symptoms of Alzheimer’s disease to a deficiency of cholinergic
neurotransmission. It’s suggested that these drugs improve cholinergic function by increasing
acetylcholine through reversible inhibition of its hydrolysis by cholinesterase. Memantine is an
NMDA receptor antagonist. Persistent activation of the NMDA receptors is thought to contribute to
symptoms of Alzheimer’s disease. There is no evidence that any of the drugs alter the course of the
underlying disease process.
ADVERSE REACTIONS
Weight loss, diarrhea, anorexia, nausea, vomiting, dizziness, headache, bradyarrhythmias;
hypertension and constipation (memantine).
CONTRAINDICATIONS AND CAUTIONS
Contraindicated in patients hypersensitive to any of the drug components.
May exaggerate neuromuscular blocking effects of succinylcholine-type and similar neuromuscular
blocking agents used during anesthesia.
Use cautiously with concomitant drugs that slow heart rate. There is an increased risk for heart
block.
Use cautiously with NSAIDs because the drug increases gastric acid secretion. There is increased
risk of developing ulcers and active or occult GI bleeding.
Use cautiously in patients with moderate hepatic or renal impairment. The drugs are not
recommended in severe hepatic impairment or severe renal impairment (creatinine clearance less
than 9 ml/ minute).
Use cautiously in patients with a history of asthma or COPD.