Galantamine Cholinergics

CYP3A4 and 2D6 are the major enzymes involved in the metabolism of galantamine. Pharmacokinetic studies with inhibitors of this system have resulted in increased galantamine concentrations or reductions in clearance. Similarly to donepezil, if inhibitors are given concurrently with galantamine, monitoring for increased cholinergic side effects should be done. Studies with inducers of these enzymes have not been completed.37... 

Lilienfeld, S. (2002) Galantamine—a novel cholinergic drug with a unique dual mode of action for the treatment of patients with Alzheimer s disease. CNS Drug Rev., 8, 159-176. 

Pharmacology Galantamine is a competitive and reversible inhibitor of acetylcholinesterase. While the precise mechanism of galantamine s action is unknown, it may exert its therapeutic effect by enhancing cholinergic function. Pharmacokinetics ... 

Galantamine (Razadyne) [Cholinesterase Inhibitor] Uses Alzheimer Dz Action Acetylcholinesterase inhibitor Dose 4 mg PO bid, T to 8 mg bid after 4 wk may T to 12 mg bid in 4 wk Caution [B, ] T Effect w/ suc-cinylcholine, amiodarone, dildazem, verapamil, NSAIDs, digoxin X- effect w/ anticholinergics, T risk of death vs placebo Contra Severe renal/hepadc impair Disp Tabs, soln SE GI disturbances, wt loss, sleep disturbances, dizziness, HA Interactions T Effects W/ amitriptyline, cimeddine, erythromycin, fluoxetine, fluvoxamine, ketoconazole, paroxetine, quinidine EMS Use succinylcholine w/ caudon, may need a reduced dose monitor ECG for induced conduction abnormalities OD May cause cholinergic Sxs (SLUDGE), muscle weakness, resp depression, and Szs atropine may be used as antidote... 

Hernandez CM, Gearhart DA, Parikh V, Hohnadel El, Davis LW, Middlemore ML, Warsi SP, Waller JL, Terry AVI (2006) Comparison of galantamine and donepezil for effects on nerve growth factor, cholinergic markers and memory performance in aged rats. 1 Pharmacol Exp Therapeutics 316 679-694. 

Galantamine is a cholinesterase (AChE) that enhances cholinergic function by increasing acetylcholine. It is indicated in the treatment of mild to moderate dementia of the Alzheimer type. 

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