There are also low levels of chemicals that carry messages between nerve cells
in the brain. Amyloid plaques, neurofibrillary tangles, and decreased chemical
levels impair thinking and memory by disrupting these messages and causing
nerve cells to die. The course of the disease varies from person to person.
Eventually, the patient loses mental capacity and the ability to carry out daily
activities. This can range from mild memory problems to severe brain damage.
Although there isn’t a treatment that stops Alzheimer’s disease, there are
medications that provide some relief to patients who are in the early and middle
stages of the disease.Tacrine (Cognex), donepezil (Aricept), rivastigmine (Exelon),
and galantamine (Reminyl)
These drugs prevent some symptoms from becoming worse for a limited time.Memantine (Namenda)
This medication is used to treat moderate to severe cases.Tranquilizers, mood elevators, and sedatives
These can help control behavioral symptoms such as sleeplessness, agitation,
wandering, anxiety, and depression.A list of anticholinergic drugs is provided in the Appendix. Detailed tables
show doses, recommendations, expectations, side effects, contraindications, and
more; available on the book’s Web site (see URL in Appendix).(^292) CHAPTER 15 Nervous System Drugs
Effects of Cholinergic and Anticholinergic Drugs
Body Tissue Cholinergic Response Anticholinergic Response
Cardiovascular Decreases heart rate, lowers blood Increases heart rate with
pressure due to vasodilation, large doses. Small doses
and slows conduction of can decrease heart rate.
atrioventricular node.
Gastrointestinal+ Increases the tone and motility Relaxes smooth muscle
of the smooth muscles of the tone of GI tract, decreasing
stomach and intestine. Peristalsis GI motility and peristalsis.
is increased and the sphincter Decreases gastric and
muscles are relaxed. intestinal secretions.
Tissue responses to large doses of cholinergic drugs
- Major tissue responses to normal doses of cholinergic drugs