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Constipation (Advanced pharmacology) - Assignment Example

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The commonly used drugs available in the market for the treatment of dementia include: Donepezil (Aricept), Galantamine (Razadyne ER), Memantine (Namenda), Rivastigmine (Exelon). Tacrine which is also a acetylcholinesterase inhibitor and which was used for treating mild to…
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Constipation (Advanced pharmacology)

It is given in a low dose initially and later increased to the maximum dose for effectiveness. However, in cases where the individual does not respond to Aricept and the dementia worsens, doctors begin prescription with Namenda which has been approved for the treatment of advanced forms of the disease. In some cases both the drugs are also given in combination. Screening of dementia in a primary care setting initially utilizes a rapid screening tool for memory loss such as the Mini-Cog or Family Questionnaire which are easy and can be administered by nurses or a medical assistant. If these initial tools are indicative of memory loss the patient is then subjected to a second cognitive assessment using tools such as Mini Mental State Examination which also take about 10-15 minutes to administer. Based on the scores the person is referred to a dementia specialist. The pharmacokinetic and pharmacodynamics properties of the four drugs used in dementia are different. Donepezil selectively inhibits acetylcholinesterase with a half-life of 70 h, Galantamine is also a selective inhibitor of acetylcholinesterase but also has a modulating effect on presynaptic nicotinic receptors and has a half-life of 6-8 h. both these drugs are metabolized by specific cytochrome oxidases in the liver. Rivastigmine is an irreversible inhibitor of both acetyl- and butyrylcholinesterase with a short half-life of 1-2 h. It is metabolized by esterases in the liver and intestine. Memantine is a low-affinity antagonist of NMDA class of receptors and has a half-life of 70 h. It is mainly eliminated unchanged via the kidneys. The most common adverse effects of acetylcholinesterase are nausea, vomiting diarrhea, muscle cramps, fatigue, headache, pain, common cold, and urinary incontinence. Rare side effects include bradycardia and sinoartrial and atrioventricular blocks. In case of Memantine, drug hypersensitivity, dizziness, hypertension, constipation and headache are common. ... Read More
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