Alzheimer's disease is a progressive neurodegenerative disorder and the most common cause of dementia in older individuals. It is characterized by degeneration of cholinergic neurons in the brain, resulting in a deficiency of the neurotransmitter acetylcholine and impaired memory and cognition. Anti-Alzheimer's drugs are used to treat AD by enhancing cholinergic transmission through anticholinesterases, suppressing excitotoxicity in the brain via NMDA antagonists, or enhancing cognition with cognition enhancer drugs. Common anticholinesterases include donepezil and rivastigmine, which inhibit the acetylcholinesterase enzyme to increase brain acetylcholine levels and overcome cholinergic deficiency. Memantine is an

1. ALZHEIMER’S DISEASE
Alzheimer’s disease (AD) is a progressive
neurodegenerativedisorder which affects older individuals and is
the most common cause of dementia. There is degeneration of
cholinergic neurons in the brain; hence the deficiency of Ach is
responsible for impaired memory and cognition in patients.

2. ANTI- ALZHEIMER’S DRUGS
• These are agents which are used to treat either by:-
1. Enhancing the cholinergic transmission- Anticholinesterases
2. Supress the excitotoxicity in the brain – NMDA antagonist
3. Enhancing cognition and memory – cognition enhancer
drugs

3. CLASSIFICATION
1. Cholinergic activators: Tacrine, Rivastigmine, Donepezil,
Galantamine
2. Glutamate (NMDA) antagonist:
:- Memantine
3. Miscellaneous cerebroactive drugs:
:- Piracetam, Pyritinol
Dihydroergotoxine,Citicoline,
Piribedil, Ginkgo biloba.

4. 1. Anticholinesterases- donepezil, rivastigmine

5. MECHANISM OF ACTION OF AchEs
• Anticholinesterases such as donepezil, rivastigmine etc will inhibit
the enzyme acetylcholinesterase
• This prevent the hydrolysis of acetylcholine; and thereby improves
brain Ach levels, which helps to overcome cholinergic deficiency in
AD.
ADVERSE EFFECTS
Hypersecretion
Bradycardia
Muscle cramps
Diarrhoea

6. USES
1. Rivastigmine is indicated in mild to- moderate cases of AD
2. Donepezil produces symptomatic improvement in moderate
to severe AD.
2. NMDA antagonist- Memantine
• Memantine which is also an antiviral drug acts by blocking
NMDA receptor mediated excitotoxicity of glutamate in AD
• Memantine is used in almost all types of dementia
3.Cognition enhancers- Pyracetam, pyritinol, Ginkgo biloba
• These are cerebroactive drugs which act as nootropic agents
(cognition enhancers) which improve cerebral blood flow;
and produces cognitive improvement in AD patients.

7. ADVANCED AD RESEARCH