UPDATE
What are common side effects of Galantamine (Razadyne)?
Gastrointestinal symptoms (nausea, vomiting, diarrhea, anorexia, weight loss),
headache, dizziness, and fatigue.
What precautions should be taken when prescribing Galantamine (Razadyne)?
Consider NSAID use, GI bleed, asthma or COPD, and concurrent use with medications
that slow heart rate.
What are the contraindications for Galantamine (Razadyne)?
Severe hepatic impairment and severe renal impairment.
What are the major metabolizing enzymes for Galantamine (Razadyne)?
CYP3A4 and CYP2D6.
What is the mechanism of action of Memantine?
Memantine prevents glutamate from binding at NMDA receptors, protecting neurons
from excessive calcium influx.
What are common side effects of Memantine?
Gastrointestinal symptoms (constipation, diarrhea, weight gain), urinary frequency,
confusion, dizziness, headache, and cough.
What precautions should be taken when prescribing Memantine?
Consider concurrent use with amantadine, rimantadine, ketamine, or dextromethorphan,
severe hepatic impairment, and severe renal impairment.
What are the prescribing pearls for Memantine?
It can be used as monotherapy or with ChEIs; fall precautions are required when used
with ChEIs.
What is the relationship between Memantine and life expectancy compared to
donepezil?
Memantine is associated with increased life expectancy when compared to donepezil.
What should patients and families be educated about regarding Alzheimer's
medications?
Medications cannot halt or reverse the progression of Alzheimer's disease.
, What is a notable side effect of donepezil at higher doses?
Higher incidence of adverse effects without increased cognitive benefit.
What is the recommendation regarding antipsychotics for dementia-related
agitation?
Antipsychotics are not recommended for the treatment of dementia-related agitation and
behavioral symptoms.
What is the recommendation regarding cholinesterase inhibitors in pregnancy
and lactation?
Cholinesterase inhibitors are not recommended during pregnancy and lactation.
What is being researched in relation to Alzheimer's disease biomarkers?
Investigating whether changes in blood levels of specific markers (tau, beta-amyloid)
may be associated with Alzheimer's-related changes.
Pharmacologic Treatment of Bipolar Disorder
Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression
major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest
(13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD)