2. Acetylcholinesterase inhibitors

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8 Terms

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Common indications (2)

  1. Mild to moderate Alzheimer’s

  2. Mild to moderate dementia in Parkinson’s

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Drugs included (2)

  1. Donepezil

  2. Rivastigmine

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Moa

  • Inhibit cholinesterase enzymes

  • Which break down acetylcholine in Cns

  • increasing the Availability of acetylcholine for neurotransmission

  • improving cognitive function and reducing cognitive decline

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Important adverse effects

GI Upset

Asthma / COPD= bronchospasms

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Warnings / contraindications

  • Caution in asthma and copd patients

  • Avoided in patients with heart block and sick sinus syndrome

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Important interactions

  • NSAIDs + systemic corticosteroids = increases risk of peptic ulcers

  • Use with antipsychotics = increases risk of neuroleptic malignant syndrome

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Dose

  • Starting dose donzepil= 5mg daily

  • Rivastigmine= 1.5mg 12 hourly

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Monitoring

  • review adverse effects 2-4 weeks after initiation of treatment or dosage adjustments

  • At 3 months repeat cognitive assessment to assess treatment efficacy