Alzheimer's disease is a progressive brain disease that destroys memory and thinking skills. It was first described by Alois Alzheimer in 1906. Symptoms include memory loss, problems with thinking and language, and behavioral issues. The main risk factor is age, although genetic factors and lifestyle may also play a role. Treatment focuses on managing symptoms, as there is currently no cure. Drugs used include cholinesterase inhibitors like donepezil and memantine, an NMDA receptor antagonist, which both aim to improve communication between neurons. Newer treatments under investigation target alternative energy sources for brain cells.

1. ALZHEIMER’S DISEASE
Ms. Pradnya Gondane
Assistant Professor
Gurunanak College of Pharmacy
Nagpur

2. LEARNING OBJECTIVES
After watching this video, you will be able to
• Understand the disease.
• Apply the basic pharmacological knowledge in
the treatment of disease.
• Understand the chemistry of drugs with
respect to their pharmacological activity.

3. INTRODUCTION
• Alzheimer's disease (AD), also known as Senile
Dementia of the Alzheimer Type (SDAT) or
simply Alzheimer’s is the most common form
of dementia. This incurable, degenerative,
terminal disease was first described by a
German psychiatrist and neuropathologist
Alois Alzheimer in 1906 and was named after
him.

4. INTRODUCTION
• Alzheimer's disease (AD) is a slowly
progressive disease of the brain that is
characterized by
– impairment of memory
– eventually by disturbances in reasoning, planning,
language, and perception.
• Generally, it is diagnosed in people over
65 years of age, although the less-prevalent
early onset of Alzheimer’s can occur much
earlier.

5. MANISFESTATIONS AND CAUSES
• Loss of memory.
• Senile dementia.
• Intraneuronal neurofibrillary tangle formation.
• Genetic patters.
• Beta-amyloid plague development.
• The role of estrogen in the brain.
• Inflammatory and oxidative stress processes.

7. AMYLOID PLAQUES

11. SIGNS AND SYMPTOMS
• MILD
• Disorientation to date
• Impaired recall
• Diminished insight
• Irritability
• MODERATE
• Increased disorientation
• Difficulties with comprehension
• Poor judgments
• Aggression

12. SIGNS AND SYMPTOMS.
• Restlessness
• Psychosis
• Sleep disturbances
• SEVERE
• Unable to use language appropriately
• Urinary and fecal incontinence

14. COMPLICATIONS
• Pneumonia
• Malnutrition and dehydration
• Aspiration
• Injury from wandering, violent behavior , or
unsupervised activity.

15. REFLECTION SPOT
• At what age Alzehemier’s Disease usually
begins? Is it genetically transmitted?

16. TREATMENT
• Behavioral therapy.
• Nonsteroidal anti-inflammatory drugs
• Cholesterol lowering drugs
• Estrogen
• NMDA antagonists like Memantine
• Cholinesterase inhibitors such as Tacrine,
Donepezil,Galantamine,Rivastigmine

17. DRUGS USED IN AD
• NMDA Antagonist
• Glutamate is the principal excitatory NT in
brain which acts on post synaptic NMDA
receptors.
• Glutaminergic overstimulation may result in
neuronal damage (excitotoxicity) implicates in
dementia.
• Eg. Memantine

18. DRUGS USED IN AD
• MEMANTINE(COGNEX)
• It is a novel NMDA
receptor antagonist , and
has been shown to be
moderately clinically
efficacious.
• It acts on the
glutaminergic system by
blocking NMDA glutamate
receptors.

19. DRUGS USED IN AD
• AchE inhibitors (AchEIs)
• These agents prevent the breakdown of Ach in
brain.
• Ach plays a major role in memory & learning;
higher level in the brain help nerve cell
communicate more efficiently.
• Eg. Donzepil, galantamine and rivastigmine.

20. DRUGS USED IN AD
• DONEPEZIL(ARICEPT)
• Acetylcholinesterase
inhibitor
• It also used to
increase cortical Ach

21. DRUGS USED IN AD
• GALANTAMINE
• Used in the
symptomatic treatment
of polio
• Was later developed
into an Alzheimer
medication.
• It also stimulate N-
receptors to release
more Ach in the brain.

22. DRUGS USED IN AD
• RIVASTIGMINE
(ELEXON)
• It is used for the
treatment of mild to
moderate dementia of
the Alzheimer’s type
and dementia due to
Parkinson’s disease.

23. Newer Drugs
• Caprylidene (axona) (1-Octyne)
• MOA:- Brain-imaging scans of older adults & those with
Alzheimer’s disease reveal a dramatically decreases uptake of
glucose, the brain’s preferred source of energy.
• It is being developed to replace these depleted glucose levels
to treat age-associated memory impairment (AAMI) &
Alzheimer's disease.
• Caprylic triglyceride is converted by the liver into ketone
bodies, which provide an alternative fuel for brain cells.
• Ketone bodies are naturally occurring compounds that are
mainly by the liver from fatty acids during periods of extended
fasting.
• The formed ketone bodies have the property to protect
neuron cells.

24. REFERENCES
• Textbook of Medicial Chemistry by
Algarswamy Volume I
• Foye’s Principle of Medicinal Chemistry
• Willson & Giswold’s Textbook of Organic
Medicinal and Pharmaceutical Chemistry