Alzheimer's disease is a progressive neurologic disorder that causes the brain to shrink (atrophy) and brain cells to die. Alzheimer's disease is the most common cause of dementia — a continuous decline in thinking, behavioral and social skills that affects a person's ability to function independently.

1. Vijay salvekar
Dept. of Pharmacology
GRY Institute of Pharmacy

3.  Alzheimer's is the most common form of dementia.
 It is a neurodegenerative disease that occurs in the brain.
 Alzheimer’s disease causes a deterioration in the brain by
destroying the nerve cells. Once the nerve cells begin to
deteriorate it causes a reduction of responses to other
nerve cells.

4.  The first person to describe this disease

5.  The first Alzheimer Patient in History
 Auguste Deter

6.  Generally, it is diagnosed in people over 65 years of age,
although the less-prevalent early onset of Alzheimer’s can
occur much earlier.
 In 2006, there were 26.6 million sufferers worldwide.
 Alzheimer’s is predicted to affect 1 in 85 people globally
by 2050.

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Alzheimer’s affects the brain.
Alzheimer's causes neurons to die which causes the brain
to shrink. This leads to a loss of functioning capabilities in
almost all parts of brain, not just the ones that affect
memory.
This leads to the formation of clumps and tangles within
the brain and eventually leads to death.
When you have Alzheimer’s the cerebral cortex shrinks
massively. The cerebral cortex is the outer surface of the
brain and it is responsible for all intellectual functioning.
The spaces in the folds of the brain (the sulci) are grossly
enlarged.
You cannot catch or spread Alzheimer’s
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11.  Short term memory loss – forgetting recent events, names
and places
Difficulty performing familiar tasks
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 Disorientation especially away from your normal
surroundings
Increasing problems with planning and managing
Trouble with language
Rapid, unpredictable mood swings
Lack of motivation
Changes in sleep and confusion about the time of day
Reduced judgement e.g. being unaware of danger
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15.  Memantine is the first in a novel class of Alzheimer's
disease medications acting on the glutamatergic system
by blocking NMDA receptors. It was first synthesized by Eli
Lilly and Company in 1968. Memantine is marketed under
, Namenda by Forest,
the brands Axura and Akatinol by
Ebixa and and Memox by Unipharm.
Pharmacokinetic data
Bioavailability ~100%
Metabolism Hepatic (<10%)
Biological half-life 60–100 hours
Excretion Renal
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16.  Memantine is a clinically useful drug in many neurological
disorders, including Alzheimer's disease. The principal
mechanism of action of memantine is believed to be the
blockade of current flow through channels of N-methyl-d-
aspartate (NMDA) receptors — a glutamate receptor
subfamily broadly involved in brain function. Surprisingly,
other drugs that block NMDA receptor channels, such as
ketamine, exhibit serious deleterious effects. The unusual
therapeutic utility of memantine probably results from
inhibitory mechanisms shared with ketamine, combined
with actions specific to memantine. These potentially
important differences between memantine and ketamine
include effects on gating of blocked channels and binding
of memantine to two sites on NMDA receptors

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Wernicke-Korsakoff syndrome.
Huntington disease.
Bipolar disorder.
Treatment of opioid-resistant cancer pain.
Clinical trials of memantine in neuropathic pain have not
been promising so far, and its routine use in neuropathic
pain is not currently recommended
Memantine has been used for the treatment of vascular
dementia, but currently there is insufficient evidence to
recommend use in pure vascular.
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18.  Namenda (memantine hydrochloride) is contraindicated in
patients with known hypersensitivity to memantine
hydrochloride or to any excipients used in the
formulation.

19.  Aricept
Donepezil
Used to delay or slow the symptoms of AD
• Loses its effect over time
• Used for mild, moderate and severe AD
• Does not prevent or cure AD
 Celexa
Citalopram Used to reduce depression and anxiety
• May take 4 to 6 weeks to work
• Sometimes used to help people get to sleep
 Depakote
Sodium Valproate
Used to treat severe aggression
• Also used to treat depression and anxiety
 Exelon
Rivastigmine
Used to delay or slow the symptoms of AD
• Loses its effect over time
• Used for mild to moderate AD
• Can get in pill form or as a skin patch
• Does not prevent or cure AD

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Used to reduce depression and anxiety
•May take 4 to 6 weeks to work
•Sometimes used to help people get to sleep
Depakote® (DEP-uh-cote)
Sodium valproate (so-DEE-um VAL-pro-ate)
Used to treat severe aggression
•Also used to treat depression and anxiety
Exelon® (EKS-uh-lawn) Rivastigmine
(riv-uh-STIG-meen)
Used to delay or slow the symptoms of AD
•Loses its effect over time
•Used for mild to moderate AD
•Can get in pill form or as a skin patch
•Does not prevent or cure AD
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21.  Namenda
Memantine
Used to delay or slow the symptoms of AD
• Loses its effect over time
• Used for moderate to severe AD
• Sometimes given with Aricept®, Exelon®
• Does not prevent or cure AD
Used to prevent or slow the symptoms of AD
• Loses its effect over time
• Used for mild to moderate AD
• Can get in pill form or as a skin patch
• Does not prevent or cure AD
Used to reduce depression and anxiety
• May take 4 to 6 weeks to work
• Sometimes used to help people get to sleep
Used to treat severe aggression
• Also used to treat depression and anxiety
 Razadyne
Galantamine
 Zoloft
Sertraline
 Trileptal
Oxcarbazepine
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Tegretol
Carbamazepine
Remeron
Mirtazepine
Used to treat severe aggression
• Also used to treat depression and anxiety
Used to reduce depression and anxiety
• May take 4 to 6 weeks to work
• Sometimes used to help people get to sleep
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22.  Levodopa was developed in the late 1960s and was the first
medication proven effective in treating a chronic
neurodegenerative disease like PD.
 Levodopa in pill form is absorbed in the blood from the small
intestine and travels through the blood to the brain, where it is
converted into dopamine.
Levodopa is almost always given in combination with another
medication called Carbidopa. Carbidopa is also a levodopa
enhancer.
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24. Nausea
Vomiting
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Loss of appetite
Lightheadedness
Lowered blood pressure
Confusion
Dyskinesia
Uncommon Side Effects
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Sleepiness, sudden onset sleep
Impulse control disorders (compulsive behaviors) such as
excessive gambling, shopping, internet use or increased
sexual behavior

25.  Tacrine improves the function of nerve cells in the brain.
It works by preventing the breakdown of a chemical called
acetylcholine. People with dementia usually have lower
levels of this chemical, which is important for the
processes of memory, thinking, and reasoning.
 Tacrine is used to treat mild to moderate dementia caused
by Alzheimer's disease.
 Tacrine may also be used for purposes other than those
listed in this medication guide.

26.  The mechanism of tacrine is not fully known, but it is
suggested that the drug is an anticholinesterase agent
which reversibly binds with and inactivates
acetylcholine released
cholinesterases. This inhibits the hydrolysis of
from functioning cholinergic
neurons, thus leading to an accumulation of acetylcholine
at cholinergic synapses. The result is a prolonged effect of
acetylcholine.

27. confusion, hallucinations;
extreme or sudden changes in behavior;
seizure (convulsions);
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pain or burning when you urinate; or
nausea, stomach pain, low fever, loss of appetite, dark
urine, clay-colored stools, jaundice (yellowing of the skin
or eyes).
Less serious side effects of tacrine include:
mild nausea, vomiting, diarrhea, upset stomach;
weight loss;
urinating more than usual;
agitation, depressed mood;
fever or chills, runny nose, cough;
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28.  Galantamine improves the function of nerve cells in the
brain. It works by preventing the breakdown of a chemical
called acetylcholine .People with dementia usually have
lower levels of this chemical, which is important for the
processes of memory, thinking, and reasoning.
 Galantamine is used to treat mild to moderate dementia
caused byAlzheimer's disease.
 Galantamine may also be used for purposes not listed in
this medication guide.

29.  Galantamine is a phenanthrene alkaloid and a reversible,
competitive acetylcholinesterase inhibitor. It is not
structurally related to other acetylcholinesterase
inhibitors. Galantamine's proposed mechanism of action
involves the reversible inhibition of acetylcholinesterase,
which prevents the hydrolysis of acetycholine, leading to
an increased concentration of acetylcholine at cholinergic
synapses.
nicotinic
Galantamine also binds allosterically with
acetylcholine receptors and may possibly
potentiate the action of agonists (such as acetylcholine) at
these receptors.

30. chest pain, slow heart rate;
feeling like you might pass out;
blood in your urine or stool;
painful or difficult urination;
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urinating less than usual or not at all;
weakness, confusion, decreased sweating, extreme thirst,
hot dry skin; or
Less serious side effects may include:
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feeling tired, dizzy, or drowsy;
headache, blurred vision, runny nose;
depression, sleep problems (insomnia);
nausea, vomiting, stomach pain, loss of appetite;
weight loss; or