Imagine losing your memories, your identity and recognition of your closest friends and family. Those with Alzheimer's disease (AD) are unable to recover memories because of degeneration of neurons in the brain. AD is a non-lethal chronic disease that can devastate families. Treatments seek to maintain the dignity, comfort and independence of the Alzheimer's patient, according to the National Institute on Aging. As with all treatments, there are side effects that weigh in the decision of what medications are preferable.
Razadyne (Galantamine)
Galantamine, with the brand name Razadyne, is an acetylcholinesterase inhibitor useful in the treatment of Alzheimer's. It helps improve memory and thinking. Like most of the cholinesterase inhibitors, there is no evidence that galantamine alters the course of the disease,. However, it improves memory and cognition, allowing people with Alzheimers to prolong independence. Cautious use of galantamine is recommended for those with hepatic (liver) impairment. When using galantamine during surgery, reduction in performance of some neuromuscular blocking agents may occur. Acetylcholinesterase inhibitors are also known to cause heart block. Most of the adverse affects attributed to galantamine can be avoided by following the recommended dosages.
Exelon (Rivastigmine)
Rivastigmine, or Exelon, is another example of an acetylcholinesterase inhibitor. Breaking down the enzyme acetylcholinesterase prevents removal of acetylcholine, making it more available in the brain. Rivastigmine is associated with gastrointestinal side effects. Nausea or vomiting is reported in approximately half of patients, according to DailyMed. It should be noted that these symptoms improved over time. Weight loss and decreased appetite were also commonly reported. Similar to other cholinesterase inhibitors, rivastigmine causes heart and anesthetic interference.
Aricept (Donepezil)
Donepezil, also known as Aricept, belongs to the family of acetylcholinesterase inhibitors similar to galantamine (Razadyne), rivastigmine (Exelon) and tacrine (Cognex). It works by blocking the breakdown of the neurotransmitters thought to modify memory and thinking, so it is used in the management of AD. Donepezil has a similar profile to other acetylcholinesterase inhibitors. In addition, the oral form of donepezil contains sulfite. Those with sulfa allergies should avoid this drug, as it may cause a severe allergic reaction. This is seen more commonly in asthmatic patients.
Cognex (Tacrine)
Tacrine, known as Cognex, is one of several available cholinesterase inhibitors on the market used in the treatment of Alzheimer's to improve a patient's overall quality of life. By increasing cognition and memory, the drug helps patients maintain independence longer. Like other cholinesterase inhibitors, it does not change the course of the disease; it improves symptoms. Tacrine should be used with caution by patients with heart conduction abnormalities, those undergoing surgery and those with seizure disorders. Tacrine reversibly inhibits cholinesterase activity and may cause slowing of the heart. Liver injury is one of its major side effects. If caught early, long term injury does not occur. Patients with predetermined liver impairment should not use tacrine.
Nemanda (Memantine)
Memantine, or Nemanda, is used during severe cognitive and memory decline. Memantine affects an entirely different neurotransmitter in the brain, working differently than acetylcholinesterase inhibitors. Memantine binds receptors that glutamate would normally occupy. Inhibiting glutamate slows brain cell death caused by the glutamate; it does not reverse the AD process or slow degeneration. It improves daily functioning in AD patients. The most reported side effects of memantine were dizziness, headache and confusion. In clinical controlled trials, according to DailyMed.nlm.nih.gov, no adverse events were more than twice that of the group that did not take the drug. In most cases, less than 5 percent of patients experienced adverse events. There were no other clinically reportable changes among research groups.
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