Cognex tacrine

The anainoacridines, tacrine (19) and its 1-hydroxy metaboUte, velnacrine (20), are reversible inhibitors of AChE. Tacrine was synthesi2ed in the 1940s and has been used clinically for the treatment of myasthenia gravis and tardive dyskinesia (115). Placebo-controUed studies have indicated modest efficacy of tacrine to treat AD dementia (122,123) and in 1993 the dmg was recommended for approval by the PDA under the trade name Cognex. Tacrine (19) has been shown to interact with sites other than AChE, such as potassium channels (124) and muscarinic receptors. However, these interactions are comparatively weak and are not thought to contribute to the biological activity of the dmg at therapeutic levels (115). 

Tacrine (Cognex). Tacrine was hrst nsed in the 1940s to reverse the respiratory depressant effects of morphine. In the late 1980s, tacrine was first used to treat dementia. The results were promising. Nearly one-third of dementia patients in the early and middle stages of illness exhibit observable improvement with tacrine. 

Clindagel, Clindets, Dalacin, Dalacin C, Dalacine, Cognex tacrine... 

Compiled from package inserts for Aricept (donepizil), Reminyl (galantamine)/ Namenda (memantine)/ Excelon (rivastigmine), and Cognex (tacrine)d° ... 

Eirst Horizon Pharmaceutical Corporation. Cognex (tacrine hydrochloride) package insert. Roswell, GA, 2000. 

Cognex (Tacrine hydrochloride). First Horizon Pharmaceutical Corp. US Prescribing information, January 2002. 

Although controversy exists over the cholinergic involvement in AD dementia, as of 1993 the only AD therapy approved by the U.S. FDA was the cholinesterase inhibitor, tacrine [321-64-2] C 2H 4N2, sold as Cognex (Warner-Lambert). 

A patient is prescribed tacrine (Cognex) for mild dementia related to AD. The nurse has a meeting with the patient and family. What patient assessments would you need to make before discussing the drug regimen with the patient What would you include in a teaching plan for the patient and family ... 

Several inhibitors of AChE have been developed for use in treating Alzheimer s disease, which requires that the drugs readily enter the CNS. These inhibitors are structurally unrelated and vary in their mechanism of inhibition, although all are reversible inhibitors. Tacrine (Cognex) is a monoamine acridine. Donepezil (Aricept) is a piperidine derivative that is a relatively specific inhibitor of AChE in the brain, with little effect on pseudo-ChE in the periphery. Galanthamine (Reminyl) is a tertiary alkaloid and phenanthrene derivative extracted from daffodil bulbs that is a reversible competitive inhibitor of AChE it also acts on nicotinic receptors. 

Tacrine Cognex Administer 10 mg po qid for 4 weeks, dien 20 mg qid for 4 weeks, then 30 mg qid for 4 weeks, and dien 40 mg qid. Titration is based on tolerability and serum transaminase levels. Refer to current product labeling for guidelines on dose adjustments, monitoring, and rechallenging. 10-, 20-, 30-, 40-mg capsules... 

Only four inhibitors of AChE have been approved as therapeutic drugs for combating dementia diseases. The very first is tacrine or Cognex [Figure 2] from Parke-Davis8 and the second is aricept from Eisai [Japan] and Pfizer [U.S.].9 A third inhibitor available is huperzine A, a "nootropic" agent isolated from a Chinese folk medicine and used by Chinese for centuries to improve memory.10 Other known reversible AChE inhibitors... 

USAN Tacrine Trade name Cognex Pfizer Inc Launched 1993... 

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