Medical, Drugs, Pharmaceuticals And Diseases Information

An acetylcholinesterase inhibitor or anti-cholinesterase is a chemical that inhibits the cholinesterase enzyme from breaking down acetylcholine, so increasing both the level and duration of action of the neurotransmitter acetylcholine.

Donepezil- trade name Aricept is a centrally acting reversible acetyl cholinesterase inhibitor. It is used in the treatment of Alzheimer’s disease where it is used to increase cortical acetylcholine. Currently, there is no conclusive proof that donepezil halts/decreases the progression of Alzheimer’s disease. However many controlled studies have shown modest benefits in cognition and behavior. Many neurologists, psychiatrists, and primary care physicians use donepezil in patients with severe Alzheimer’s disease. But there is no significant improvement in functional outcome, of quality of life or of behavioral symptoms in those with mild to moderate Alzheimer’s disease. Donepezil comes as a tablet and dissolves quickly in the mouth. It is usually taken once a day, in the evening with or without food. The medicine is taken around the same time every day. It may take several weeks before the full benefits of donepezil are experienced . This drug helps control the symptoms of Alzheimer’s disease but does not cure it. It has to be taken even if the patients feels well and not stopped without talking to doctor.

 
  
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There are a range of medications approved by regulatory agencies such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) to treat the cognitive manifestations of Alzheimer ’s disease. The drugs are mostly acetyl cholinesterase inhibitors. There is also NMDA receptor antagonist like Memantine. However no medication currently available can delay or halt the progression of the Alzheimer’s Disease..

Reduction in the activity of the cholinergic neurons is a well-known feature of Alzheimer’s disease. Acetyl cholinesterase inhibitors are employed to reduce the rate at which acetylcholine is broken down, thereby increasing the concentration of Acetyl cholinesterase in the brain and combating the loss of Acetyl cholinesterase caused by the death of cholinergic neurons. The cholinesterase inhibitors approved for the management of AD symptoms are donepezil (Aricept), Galantamine (Razadyne), and rivastigmine ( Exelon and Exelon Patch). There is evidence for the efficacy of these medications in mild to moderate Alzheimer’s disease, and some evidence for their use in the advanced stage.

Donepezil is approved for treatment of advanced AD dementia. The use of these drugs in mild cognitive impairment has not shown any effect in a delay of the onset of Alzheimer’s disease. The most common side effects are nausea and vomiting, both of which are linked to cholinergic excess. These side effects arise in approximately ten to twenty percent of users and are mild to moderate in severity.

Glutamate is a useful excitatory neurotransmitter of the nervous system, although excessive amounts in the brain can lead to cell death through a process called excitotoxicity which consists of the over stimulation of glutamate receptors. Excitotoxicity occurs not only in Alzheimer’s disease, but also in other neurological diseases such as Parkinson’s disease and multiple sclerosis. Memantine (brand names Akatinol, Axura, Ebixa/Abixa, Memox and Namenda), is a noncompetitive NMDA receptor antagonist . It acts on the glutamatergic system by blocking NMDA receptors and inhibiting their over stimulation by glutamate. Memantine has been shown to be moderately efficacious in the treatment of moderate to severe Alzheimer’s disease.

 
  
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Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities. The most common form of dementia among older people is Alzheimer’s disease (AD), which initially involves the parts of the brain that control thought, memory, and language. Although scientists are learning more every day, right now they still do not know what causes AD, and there is no cure. There is no cure for AD and no way to slow the progression of the disease. For some people in the early or middle stages of AD, medication such as tacrine (Cognex) may alleviate some cognitive symptoms. Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) may keep some symptoms from becoming worse for a limited time. A fifth drug, memantine (Namenda), was recently approved for use in the United States. Combining memantine with other. The likelihood of having Alzheimer’s disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85. Nonetheless, Alzheimer’s disease is not a normal part of aging and is not something that inevitably happens in later life. For example, many people live to over 100 years of age and never develop Alzheimer’s disease. AD drugs may be more effective than any single therapy. One controlled clinical trial found that patients receiving donepezil plus memantine had better cognition and other functions than patients receiving donepezil alone.

Alzheimer’s disease affects a person’s cognitive, emotional, behavioral and physical functions increasingly over time, causing many people with the disease to eventually require full time care. Caregivers often devote a majority or all or of their spare time to helping their loved one with Alzheimer’s disease.

Full-time Alzheimer’s caregivers can benefit from periodic relief from care giving duties, giving them time to nurture other relationships and return to caring for their loved one with a refreshed mindset. Caregivers can benefit from seeking assistance, either on regular intervals or as needed, from one of the following sources: Other relatives or loved ones. Other friends or family members may be willing to assume care giving responsibilities at times, particularly if they already have a close relationship with the person.

Sharing care giving responsibilities with a close friend or relative allows them to spend quality time with their loved one and gives the primary caregiver free time to fulfill unrelated needs and responsibilities. Respite Care. Respite care is professional daytime or overnight care that may be offered by a full time Alzheimer’s care home in your area. Respite care can give caregivers the comfort of knowing that their loved one is in the care of professionals who specialize in the unique needs of people with Alzheimer’s, and can give their loved one the opportunity to socialize and participate in rewarding activities. Respite care not only gives full time caregivers a break, it also gives them a chance to become familiar with a professional care home that may make a viable option for full time care for their loved one in the future. In home professional care. Another option is to hire a professional caregiver who provides in home care service.

A professional caregiver can be a convenient option, particularly for caregivers whose loved one with Alzheimer’s lives with them in their home. For some Alzheimer’s patients, remaining in a consistent environment is comforting and the most suitable temporary care option for their needs. Care giving takes on a variety of connotations for different people, ranging from occasional help to full time supervision and assistance. Caregivers closer to the full time end of the spectrum sometimes inadvertently neglect their own needs when they are consumed with caring for the daily life of a loved one, making an occasional break from care giving important for their well being and health. The appropriate short term care option for a person with Alzheimer’s depends heavily on his or her individual needs
 
 

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