1 Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
2 Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, USA.
Am J Alzheimers Dis Other Demen. 2018 Mar;33(2):73-85. doi: 10.1177/1533317517734352. Epub 2017 Oct 3.
Elderly patients with Alzheimer's disease (AD) and other dementias are at high risk of polypharmacy and excessive polypharmacy for common coexisting medical conditions. Polypharmacy increases the risk of drug-drug and drug-disease interactions in these patients who may not be able to communicate early symptoms of adverse drug events. Three acetylcholinesterase inhibitors (ACHEIs) have been approved for AD: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They are also used off-label for other causes of dementia such as Lewy body and vascular dementia. We here report evidence from the literature that ACHEI treatment, prescribed for cognitive impairment, can reduce the load of medications in patients with AD by also addressing cardiovascular, gastrointestinal, and other comorbidities. Using one drug to address multiple symptoms can reduce costs and improve medication compliance.
患有阿尔茨海默病 (AD) 和其他痴呆症的老年患者存在多种药物治疗和过度多种药物治疗常见共存疾病的高风险。对于这些可能无法及时沟通药物不良反应早期症状的患者,多种药物治疗会增加药物-药物和药物-疾病相互作用的风险。已有三种乙酰胆碱酯酶抑制剂 (ACHEI) 被批准用于 AD:多奈哌齐(安理申)、加兰他敏(艾斯能)和利伐斯的明(艾斯能)。它们也被用于治疗其他原因引起的痴呆症,如路易体痴呆和血管性痴呆。我们在这里报告的文献证据表明,乙酰胆碱酯酶抑制剂治疗,用于认知障碍,可以通过解决心血管、胃肠道和其他合并症来减少 AD 患者的药物负担。使用一种药物来解决多种症状可以降低成本并提高药物依从性。