The aims of treatment for Alzheimer's disease ...

The objectives of treatment for Alzheimer's disease are to improve cognitive function, decrease severity of behavioral disturbances and slow disease progression. For the treatment of Alzheimer's disease using drugs, acting on atsetilholinergicheskuyu system (rivastigmine, donepezil, galantamine), drugs that act on NMDA-receptors (memantine), as well as drugs neurometabolic action (Cerebrolysin, gliatilin, etc.). Attempt to influence atsetilholinergicheskuyu system is the use of acetylcholine precursors, acetylcholinesterase inhibitors and agonists of cholinergic receptors. Currently, the treatment of Alzheimer's disease most commonly used central acetylcholinesterase inhibitors (rivastigmine, donepezil, galantamine) that prevent the destruction of acetylcholine. Recently, new data concerning the dual mechanism of action of rivastigmine (Exelon, a pharmaceutical company Novartis), which distinguishes it from this group of drugs. It was shown that, in addition to acetylcholine, the regulation of the level of acetylcholine in the brain by another enzyme - butyrylcholinesterase. Dual mechanism of action of rivastigmine is the ability to inhibit and acetylcholinesterase, and butyrylcholinesterase. In addition, Exelon not only increases due to reduced disease levels of acetylcholine in the brain, but also increases cerebral blood flow in the frontal, parietal and temporal divisions that is accompanied by improvement in cognitive patients. Treatment is initiated with a dose of 1-2 mg / day. and gradually increased to 12 mg / day. Investigation of clinical efficacy of Exelon, the Scientific and methodological center for the study of Alzheimer's disease and associated disorders SCMH Medical Sciences, showed that the drug Exelon is a safe treatment for patients with Alzheimer's disease with mild to moderate dementia. This is evidenced by the virtual absence of serious adverse events during 6-month course of therapy with maximum tolerable doses (ranging from 3 to 12 mg daily). Lightweight and expressed mild adverse events occurred mainly during the period of titration doses. Clinical efficacy of 6-month course of treatment with Exelon established by cognitive scales MMSE and ADAS-cog, and based on general clinical impressions of the researcher and the person carer patient. Thus, given the above data, Exelon can be recommended for medical use as an effective and safe drug for treatment of Alzheimer's disease at a stage of mild to moderate dementia. The appearance of the patients emotional and affective and psychotic disorders may require appropriate treatment. With excitement and confusion of using smaller doses of possessing a small holinoliticheskoy activity. Usually only one medication in the evening, as excitement and confusion often occur at night, a sedative effect of haloperidol helps normalize sleep and longer half-life can prevent the occurrence of arousal and the afternoon.