Description overdue on 23.06.2012

Anticholinesterase agents.   Active Ingredient - donepezil . The basic substance is a reversible, specific inhibitor cholinesterase . The principle is based on blocking effects of the decomposition of acetylcholine, that receives the main part in the transfer of excitation in the central nervous system. Active ingredient inhibits cholinesterase in the brain. In single dose of 5 and 10 mg CSS marked inhibition of cholinesterase activity by 63 and 77%, respectively (estimated from erythrocyte membranes). When long-term therapy is marked slowing the progression of Alzheimer's disease, reduces the severity of Cognitive symptoms It restored daily activity of the patient, which greatly facilitates the process of care. Aricept reduces hallucinations . apathy , Unthought repetitive motion, corrects behavioral abnormalities. The drug Aricept available in tablet form.

Indications:

Aricept prescribed for dementia , Mild to moderate Alzheimer's disease.

Contraindications:

Aricept is not indicated in case of intolerance donepezil, piperidine derivatives. In bronchial asthma, pregnancy , Ulcerative lesions of the digestive system, heart rhythm disturbances, in COPD, while taking anticholinergics, NSAID, cholinesterase inhibitors, donepezil breastfeeding used with caution.

Side effect:

Aricept can cause headaches, diarrhea, dyspeptic disorders , Vomiting, dizziness, increased CPK, atrioventricular block, SA blockade, syncope, seizures, insomnia , Fatigue.

Overdose:

It manifested in the form of cholinergic crisis : Convulsions, collapse, respiratory depression , Drop in blood pressure, bradycardia, drooling , Vomiting, severe nausea, sweating. In some cases recorded increasing   myasthenia That with the defeat of the respiratory muscles can cause the patient's death. As an antidote recommended intravenously administered 1-2 mg atropine (subsequent dose adjusted according to the condition of the patient, the effect of an antidote). Held posimptomnaya therapy. There are no data on the effectiveness of hemofiltration, peritoneal dialysis, hemodialysis.

Mode of application:

Aricept is taken before going to bed, night inside. The initial dose is 5 mg 1 time a day, the course lasts a month. If necessary, the dosage is increased up to 10 mg per day. Do not take more than 10 mg per day due to the lack of increase in proportion to the dose effect. Supportive therapy is to maintain a therapeutic effect of donepezil.

Special instructions:

Data on the safety of the drug Aricept for pregnant women, breastfeeding women do not .  Also it is known on the allocation of donepezil with breast milk when feeding children .  Drug therapy is performed under mandatory supervision of a doctor who has a wide experience in the diagnosis and treatment of Alzheimer's patients .  Diagnosis of the disease is carried out in accordance with generally accepted guidelines for ICD-10, DSM-4 .  Aricept prescribed to patients for whom being constant monitoring, which will provide regular, timely pills .  Appointment of support is carried out while maintaining a dosage efficacy .  It requires regular evaluation of the effectiveness of donepezil .  The question of the termination of therapy seen in the absence of positive dynamics on the background of the treatment .  The result of treatment can not be predicted, it is different in each case .  Effectiveness of Aricept in patients with severe Alzheimer's disease, when memory impairment , Cognitive decline is not fully understood. The treatment may increase   neuromuscular blockade Which is caused by the introduction depolarizing muscle relaxants   under general anesthesia. Cholinesterase inhibitors due to their pharmacological effects are able to provide vagotonic impact For example, to cause bradycardia. This is especially to be considered when treating patients with atrioventricular block, SA-blockade With GOKMP. Careful observation require patients with ulcerative lesions of the digestive tract, as well as those taking drugs of the NSAID. In clinical studies versus placebo showed an increase in the number of patients with gastrointestinal bleeding, ulcer . When receiving anticholinesterase agents can delay urination. Cholinesterase inhibitors in rare cases cause generalized seizures However it is worth remembering that seizure activity may be a manifestation of the underlying disease - Alzheimer's disease.

Drug Interactions:

The efficacy of Aricept unpredictable increases at reception holinostimulyatorov ; the opposite effect is registered in the appointment holinoblokatorov . Inhibitors of cytochrome P450 ( fluoxetine Quinidine,   ketoconazole , Erythromycin, itraconazole) increase the concentration of donepezil in the blood; the opposite effect is observed at the same time taking inductors MAO   ( carbamazepine , Phenytoin, ethanol, rifampicin ). NSAIDs, medicines for   general anesthesia   It leads to an increase in severity of side effects.