Medical University of Sofia, Faculty of MedicineDepartment of Pharmacology and Toxicology

Alzheimer’s DiseaseAvi Gandhi (2009)

Medical University of Sofia, Faculty of MedicineDepartment of Pharmacology and Toxicology

Background• It is the progressive mental deterioration that can occur in middle

or old age, due to generalized degeneration of the brain.

• It causes a steady loss of memory, speech, thinking, and carrying on daily activities.

• As a person becomes older the risk for developing Alzheimer’s increases.

• Annual cost can be over $50,000

• Affects over 26.6 million people worldwide

Symptoms•Memory loss

• confused about time and place

• changes in personality and mood

• trouble speaking and accomplishing tasks

7 Stages1. No impairment

2. very mild cognitive decline

3. mild cognitive decline

4. moderate cognitive decline

5. moderately severe cognitive decline

6. severe cognitive decline

7. very severe cognitive decline

Anatomical Changes

1. Neurofibrillary tangles

2. loss of neuronal synapse

3. dead or dying nerve cells

4. formation of plaques

Treatment1. Acetylcholine esterase

inhibiters

i. Rivastigmine

ii. Galantamine

iii. Donepezil

2. NMDA receptor antagonist

i. Memantine

Side Effects• nausea

• vomiting

• loss of appetite

• headache

• confusion

• constipation(memantine)

1. Antidepressants

i. Peroxeineii. Fluxetine

2. Anxiolyticsi. Lorazepam

3. Antipsychotic1. Clozapine2. Haloperidol

Behavioral Drugs

Clinical Trials1)“Alzheimer’s in Long-Term Care--

Treatment for Agitation”

2)“Cognitive Behavioral Therapy of

Early Dementia”

3)“Nefiracetam in the Treatment of

Alzheimer’s Disease”

Sources•www.wikipedia.com•Harrison’s Internal Medicine•Lippincott’s Illustrated Reviews

Pharmacology•NextBio•Modern Pharmacology with Modern

Clinical Applications•http://www.alz.org/index.asp