Aricept
Aricept
Aricept (Donepezil)Pharmacological action
Selective and reversible inhibitor of an acetylcholinesterase which is prevailing type of a cholinesterase in a brain.
After unitary Aricept reception in doses of 5 mg or 10 mg degree of suppression of activity of the acetylcholinesterase, measured in membranes of erythrocytes after preparation reception, made accordingly 63.6 and 77.3 %.
Indications
- A dementia expected treatment Alzheimer type easy or moderate severity level.
Dosage regimen
Adult (including to elderly patients) prescribe in an initial dose of 1 times/days of 5 mg Reception in an initial dose continue a preparation within not less than 4-6 weeks to reach equilibrium Donepezil concentration and to define early clinical effect of therapy. Through 1 month Aricept dose it is possible to enlarge about 10 mg/24h that is the maximum recommended daily dose.
The maintenance therapy can be continued until the therapeutic effect which should be estimated regularly remains.
At disturbances of function of a liver and kidneys of correction of doses it is not required.
Side effect
From the alimentary system: often (> 5 %) - a diarrhoeia, a nausea, vomiting.
From party TSNS and peripheric nervous system: often (> 5 %) - fatigability, a sleeplessness, muscular cramps.
From cardiovascular system: seldom - a syncope, a bradycardia, sinuatrial and AV-blockade.
In controllable clinical researches at patients also were observed:
From party TSNS: a headache, giddiness, hallucinations, a disturbing condition, aggressive behaviour, epileptic attacks.
From the alimentary system: a dyspepsia, a hepatitis, a stomach ulcer and a duodenum and a bleeding from GASTROINTESTINAL TRACT.
The other: a pain of various localisation, accidents, cold.
Contraindications
- A hypersensibility to Donepezil, to other components of a preparation, and also to piperidine derivatives.
With care it is necessary to prescribe a preparation to patients with obstructive diseases of lungs in the anamnesis (including with a bronchial asthma), with disturbances of a rhythm of heart, at anaesthesia carrying out, and also the patient with the raised risk of development of an ulcer (for example, to patients with a peptic ulcer in the anamnesis).
It is necessary to avoid simultaneous Aricept application with other inhibitors of an acetylcholinesterase, agonists or antagonists of cholinergic system.
Pregnancy and lactemia
Controllable researches of Aricept application at pregnancy and in a lactemia it was not spent. Data on Donepezil deducing with thoracal milk are not present. The preparation should be prescribed to pregnant women only in the event that the expected advantage of treatment exceeds possible risk for a foetus.
Special indicatings
The doctor having experience of conducting of patients with an Alzheimer's disease should prescribe and spend treatment. The diagnosis should be put according to the standard criteria (for example, DSM IV - the Diagnostic and statistical management on alienations of the fourth revision, ICD 10 - the International classification of illnesses of the tenth revision).
Believe, that cholinomimetics are capable to cause generalised cramps. However occurrence of cramps in reception of Aricept preparation can be also Alzheimer's disease implication.
Considering cholinomimetic action of inhibitors of a cholinesterase, Aricept is necessary to prescribe with care the patient with an asthma or obstructive diseases of lungs in the anamnesis.
Use in pediatrics
Safety and efficiency of Aricept application at children was not studied, therefore the preparation is not recommended to be prescribed this category of patients.
Influence on ability to management of motor transport and work with mechanisms
The dementia of Altsgejmerovsky type itself can be accompanied by disturbance of ability to a driving and use of difficult technics. Besides, Aricept, basically in the beginning of treatment or at dose rising, can cause fatigability, giddiness and cramps of muscles. The question on ability of the patient with a dementia of Altsgejmerovsky type during Aricept reception to control the car or to use difficult technics the doctor after an estimation of individual reaction of the patient on treatment should solve.
Overdosage
Symptoms: a cholinergic crisis (the expressed nausea, vomiting, a plentiful hypersalivation, a sweating, a bradycardia, BP depression, a respiratory depression, a collapse and cramps). Intensifying of muscular delicacy which at a lesion of respiratory muscles can lead even to a lethal outcome is possible.
Treatment: symptomatic therapy. As an antidote at Aricept overdosage it is possible to use tertiary anticholinergics, in particular atropine in an initial dose of 1-2 mg i.v., then a dose select depending on effect.
Medicinal interaction
Clinical experience of Aricept application is limited, therefore at preparation appointment it is necessary to consider risk of unknown persons till the present moment of interactions with other preparations.
Conditions and periods of storage
B.Preparat's list should be stored in a place inaccessible to children at temperature not above 30 C. The Period of validity - 3 years.
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