Which of these Cholinesterase Inhibitors is/are available as transdermal patch and apply once daily?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is/are available as oral solution?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is/are available in Extended Release (ER) formulations dose once daily?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is/are available as an orally disintegrating tablet (ODT)?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors binds REVERSIBLY to both AChE and butyrylcholinesterase?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors has roughly 1000-fold greater affinity for AChE compare to butyrylcholinesterase, as
well as greater affinity for AChE in the brain than in the periphery, reducing the risk of gastrointestinal adverse effects.?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is more specific for AChE and has no effect on butyrylcholinesterase?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

------------ is primarily found in the liver, but
is also present to a minor extent in the brain.

What is the role of Butyrylcholinesterase?

Which of these Cholinesterase Inhibitors is/are metabolized in the liver by CYP2D6 and CYP3A4?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is/are extensively metabolized by the liver w/o significant CYP involvement, w/ a half life of 3 hrs.
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors should be administered
with food to improve tolerability?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these therapeutic considerations for cholinesterase inhibitors is/are true?
a. All cholinesterase inhibitors are indicated for the treatment of mild to moderate AD.
b. Donepezil and rivastigmine patch are also indicated for severe AD.
c. Efficacy of cholinesterase inhibitors is dose-dependent.
d. The difference in MOA of cholinesterase inhibitors causes significance difference in efficacy

Which of these are part of adverse effects of Cholinesterase Inhibitors?
a. N/V/D
b. headache
c. anorexia or weight loss
d. falls, hip fractures, syncope
e. bradycardia

Which of these Cholinesterase Inhibitors is/are associated with lowest incidence of gastrointestinal adverse effects?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Which of these Cholinesterase Inhibitors is/are associated with highest incidence of gastrointestinal adverse effects?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)

Galantamine’s most significant
adverse effects also include (a) ------- (b) ------- (c) ---------
[Hint: WAD]

Which of these Cholinesterase Inhibitors and NMDA has/have no clinically significant DDI?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)
d. Memantine (Namenda)

Which of these Cholinesterase Inhibitors and NMDA has/have low potential for DDI due to low protein binding and no CYP metabolism?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)
d. Memantine (Namenda)

Which of these Cholinesterase Inhibitors and NMDA will cause an increase in cholinergic side effects when CYP450 2D6 or 3A3/4 is added to it/them?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)
d. Memantine (Namenda)

Which of these Cholinesterase Inhibitors and NMDA will cause an increase in cholinergic side effects when CYP450 2D6 or 3A3 is added to it/them?
a. Rivastigmine (Exelon)
b. Galantamine (Razadyne)
c. Donepezil (Aricept)
d. Memantine (Namenda)

Which of these therapeutic considerations for NMDA is/are true?
a. Memantine can't be used in combination with cholinesterase inhibitors.
b. The maximum dose of the extended release formulation is 14 mg/day for patients with CrCl < 30 mL/min.
c. Do not use in patients with CrCl < 5 mL/min.
d. The recommended starting dose of the extended release formulation is 7 mg/day and should be titrated in 7 mg/day increments to either the maximum tolerated dose or 28 mg/day.
e. Allow at least ONE WEEK between dose titrations to improve tolerability.

The most significant adverse effects of memantine are (a) --------- (b) --------- and (c) ----------
**[DHC]

Which of these complimentary medications is/are considered possibly effective and likely safe?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine

Which of these complimentary medications is/are considered possibly effective and possibly safe?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these complimentary medications prevent oxidative cell death of neurons by preventing lipid per oxidation and reduce the activation of transcription factors
involved in nerve cell survival?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these complimentary medications improves behavior and cognitive function and delays the progression of AD;
more likely to show benefit in patients with AD who are less than 66 years of age and have a fast rate of disease progression?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these complimentary medications has a low affinity for NMDA receptors, so its primary mechanism of action is through inhibiting cholinesterase?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these complimentary medications has clinical evidence that demonstrated improved behavioral and cognitive function, but the benefit
may be limited to only 16 weeks?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these complimentary medications may increase the risk of bleeding in patients taking aspirin, NSAID or Warfarin?
a. Vit E
b. Ginko Biloba
c. Acetyl-L-Carnitine
d. Phosphatidylserine
e. Vinpocetine
f. Huperzine-A

Which of these medications is considered second line antipsychotic agent?
a. Carbamazepine
b. Oxazepam (Serax)
c. Buspirone (Buspar)
d. Trazodone

Which of these medications is preferred for treating anxiety, agitation, and aggression?
a. Carbamazepine
b. Oxazepam (Serax)
c. Buspirone (Buspar)
d. Trazodone

Which of these medications is preferred for treating agitation and aggression with minimal adverse effects.?
a. Carbamazepine
b. Oxazepam (Serax)
c. Buspirone (Buspar)
d. Trazodone

When treating elderly with antidepressant, expect ------- weeks of treatment before seeing a response to antidepressants in the elderly

What is the first line of agent for treating depression in an elderly with AD?

Which of these medications is preferred for treating AD w/ apathy (lack of interest, enthusiasm, or concern)?
a. Carbamazepine
b. Oxazepam (Serax)
c. Buspirone (Buspar)
d. Trazodone
e. psychostimulants (e.g., methylphenidate)

Which of these statements is/are true?
a. Estrogen at the start of menopause and continued for 10 years = reduction in AD incidence.
b. Starting Estrogen at 65 yrs of age or older = increase risk of developing AD.
c. Starting Estrogen 10 yrs or more after the on set of menopause = increased risk of developing AD.
d. HRT at the time of transition into menopause = reduced risk of developing AD.
e. Estrogen therapy can be used to prevent AD but cannot be used to treat AD