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https://www.readbyqxmd.com/read/28974110/acetylcholinesterase-inhibitors-beneficial-effects-on-comorbidities-in-patients-with-alzheimer-s-disease
#1
Vinod Kaushik, Sarah Toombs Smith, Emmanuel Mikobi, Mukaila A Raji
Elderly patients with Alzheimer's disease (AD) and other dementias are at high risk of polypharmacy and excessive polypharmacy for common coexisting medical conditions. Polypharmacy increases the risk of drug-drug and drug-disease interactions in these patients who may not be able to communicate early symptoms of adverse drug events. Three acetylcholinesterase inhibitors (ACHEIs) have been approved for AD: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). They are also used off-label for other causes of dementia such as Lewy body and vascular dementia...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28670911/bioequivalence-study-of-rivastigmine-6-mg-capsules-single-dose-in-healthy-volunteers
#2
Dhiraj Abhyankar, Ashish Shedage, Milind Gole, Preeti Raut
OBJECTIVE: To assess the bioequivalence of generic formulation of rivastigmine (test) and Exelon (reference). METHODS: This randomized, open-label, 2-period, single-dose, 2-treatment, 2-sequence, crossover study was conducted in 40 healthy men under fed condition. Participants were randomized to receive a single dose of Exelon or rivastigmine capsule. RESULTS: A total of 31 participants completed the study. Area under the concentration-time curve from time zero to time t (AUC0- t) and area under the concentration-time curve from time zero to infinity (AUC0-∞) for Exelon (mean [standard deviation], h·ng/mL) were 126...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28224389/development-of-a-discriminative-in-vitro-release-test-for-rivastigmine-transdermal-patches-using-pharmacopeial-apparatuses-usp-5-and-usp-6
#3
Alice Simon, Maria Inês Amaro, Anne Marie Healy, Lucio Mendes Cabral, Valeria Pereira de Sousa
The aim of this study was to develop and validate a discriminating in vitro release test to evaluate rivastigmine transdermal patches. The Exelon® Patch was chosen as a model transdermal product. The studies of in vitro release were designed to determine the impact of the official apparatus chosen (USP apparatus 5 and USP apparatus 6), the rotation speed, and the dissolution medium characteristics on the rivastigmine release profile from transdermal patches. Patches with different drug release profiles were tested in order to evaluate the discriminating power of the in vitro release test developed and validated...
February 21, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28179735/ismp-medication-error-report-analysis-understanding-human-over-reliance-on-technology-it-s-exelan-not-exelon-crash-cart-drug-mix-up-risk-with-entering-a-test-order
#4
Michael R Cohen, Judy L Smetzer
These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program...
January 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/27568498/comparative-evaluation-of-rivastigmine-permeation-from-a-transdermal-system-in-the-franz-cell-using-synthetic-membranes-and-pig-ear-skin-with-in-vivo-in-vitro-correlation
#5
COMPARATIVE STUDY
Alice Simon, Maria Inês Amaro, Anne Marie Healy, Lucio Mendes Cabral, Valeria Pereira de Sousa
In the present study, in vitro permeation experiments in a Franz diffusion cell were performed using different synthetic polymeric membranes and pig ear skin to evaluate a rivastigmine (RV) transdermal drug delivery system. In vitro-in vivo correlations (IVIVC) were examined to determine the best model membrane. In vitro permeation studies across different synthetic membranes and skin were performed for the Exelon(®) Patch (which contains RV), and the results were compared. Deconvolution of bioavailability data using the Wagner-Nelson method enabled the fraction of RV absorbed to be determined and a point-to-point IVIVC to be established...
October 15, 2016: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/27111084/effects-on-agitation-with-rivastigmine-patch-monotherapy-and-combination-therapy-with-memantine-in-mild-to-moderate-alzheimer-s-disease-a-multicenter-24-week-prospective-randomized-open-label-study-the-korean-exelon-patch-and-combination-with-memantine-comparative
#6
Soo J Yoon, Seong H Choi, Hae R Na, Kyung-Won Park, Eun-Joo Kim, Hyun J Han, Jae-Hong Lee, Young S Shim, Duk L Na
AIM: Memantine is known to be effective in the treatment of the behavioral symptoms of dementia, especially agitation in moderate to severe Alzheimer's disease (AD). However, memantine and rivastigmine patch combination therapy has not been well studied in determining treatment effectiveness with mild to moderate AD patients. METHODS: This was a multicenter, 24-week, prospective, randomized, open-label study design. A total 147 AD patients with Mini-Mental State Examination scores from 10 to 20 were randomly assigned to rivastigmine patch monotherapy and combination therapy with memantine groups...
March 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/26393402/rivastigmine-for-alzheimer-s-disease
#7
REVIEW
Jacqueline S Birks, Lee Yee Chong, John Grimley Evans
BACKGROUND: Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity...
September 22, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26313774/a-case-report-on-dyskinesia-following-rivastigmine-patch-13-3-mg-24-hours-for-alzheimer-s-disease-perspective-in-the-movement-disorders-spectrum-following-use-of-cholinesterase-inhibitors
#8
Maria Cristina B Diaz, Raymond L Rosales
Current reports on movement disorder adverse effects of acetylcholinesterase inhibitors only include extrapyramidal symptoms and myoclonus.Here is a case of an 81-year-old female Filipino with dementia who presented with first-onset generalized choreiform movements.The etiology of the clinical finding of dyskinesia was investigated through laboratories, neuroimaging, and electroencephalogram, all of which yielded negative results. Review of her medications included the rivastigmine (Exelon) patch, which had just been increased to 13...
August 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/25858345/rivastigmine-for-alzheimer-s-disease
#9
REVIEW
Jacqueline S Birks, John Grimley Evans
BACKGROUND: Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity...
April 10, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/25755685/responder-analysis-of-a-randomized-comparison-of-the-13-3-mg-24-h-and-9-5-mg-24-h-rivastigmine-patch
#10
José L Molinuevo, Lutz Frölich, George T Grossberg, James E Galvin, Jeffrey L Cummings, Tillmann Krahnke, Christine Strohmaier
INTRODUCTION: OPtimizing Transdermal Exelon In Mild-to-moderate Alzheimer's disease (OPTIMA) was a randomized, double-blind comparison of 13.3 mg/24 h versus 9.5 mg/24 h rivastigmine patch in patients with mild-to-moderate Alzheimer's disease who declined despite open-label treatment with 9.5 mg/24 h patch. Over 48 weeks of double-blind treatment, high-dose patch produced greater functional and cognitive benefits compared with 9.5 mg/24 h patch. METHODS: Using OPTIMA data, a post-hoc responder analysis was performed to firstly, compare the proportion of patients demonstrating improvement or absence of decline with 13...
2015: Alzheimer's Research & Therapy
https://www.readbyqxmd.com/read/25100996/comparison-of-the-effects-of-transdermal-and-oral-rivastigmine-on-cognitive-function-and-eeg-markers-in-patients-with-alzheimer-s-disease
#11
Davide V Moretti, Giovanni B Frisoni, Giuliano Binetti, Orazio Zanetti
BACKGROUND: Alzheimer's disease (AD) is the most common cause of dementia in older patients. Rivastigmine (RV, Exelon, Novartis), a reversible cholinesterase inhibitor, improves clinical manifestations of AD and may enhance ACh-modulated electroencephalogram (EEG) alpha frequency. This pilot study aimed to determine the effects of two formulations of RV [transdermal patch (RV-TDP) and oral capsules (TV-CP)] on alpha frequency, in particular the posterior dominant rhythm, and cognitive function [assessed by the Mini-Mental State Examination (MMSE)] in patients with AD...
2014: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/24989628/rivastigmine-transdermal-patch-13-3-mg-24-h-a-review-of-its-use-in-the-management-of-mild-to-moderate-alzheimer-s-dementia
#12
REVIEW
James E Frampton
Rivastigmine is unique among cholinesterase inhibitors commonly used in the treatment of mild to moderate Alzheimer's disease (AD) in that it is available as a transdermal patch formulation (Exelon(®) patch, Rivastach(®) patch, Prometax(®) patch). The patch is applied once daily and, in the EU (and US), is available in three sizes: 5, 10 and 15 cm(2) (releasing 4.6, 9.5 and 13.3 mg rivastigmine/24 h, respectively). In the phase III OPTIMA trial, patients with mild to moderate AD who experienced functional and cognitive decline on the 10 cm(2) patch-the recommended maintenance dose-gained additional benefit when their dose was increased to the 15 cm(2) patch...
August 2014: Drugs & Aging
https://www.readbyqxmd.com/read/24549933/efficacy-of-higher-dose-13-3%C3%A2-mg-24-h-15%C3%A2-cm2-rivastigmine-patch-on-the-alzheimer-s-disease-assessment-scale-cognitive-subscale-domain-and-individual-item-analysis
#13
RANDOMIZED CONTROLLED TRIAL
Gustavo Alva, Richard Isaacson, Carl Sadowsky, George Grossberg, Xiangyi Meng, Monique Somogyi
OBJECTIVE: Rivastigmine displays dose-dependent efficacy on cognition in patients with Alzheimer's disease (AD), as measured by the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog). Subanalysis of the OPTIMA (OPtimising Transdermal Exelon In Mild-to-moderate Alzheimer's disease) study aimed to define ADAS-cog domains by factor analysis of individual items. Efficacy of 13.3 mg/24 h versus 9.5 mg/24 h rivastigmine patch on individual items and newly derived domains was assessed...
September 2014: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/23982674/efficacy-of-higher-dose-13-3-mg-24-h-rivastigmine-patch-on-instrumental-activities-of-daily-living-in-patients-with-mild-to-moderate-alzheimer-s-disease
#14
RANDOMIZED CONTROLLED TRIAL
George Grossberg, Jeffrey Cummings, Lutz Frölich, Giuseppe Bellelli, José L Molinuevo, Tillmann Krahnke, Christine Strohmaier
BACKGROUND: Stabilizing/reducing decline in the ability to perform activities of daily living (ADLs) is important in management of Alzheimer's disease (AD). METHODS: Post hoc analysis of OPtimizing Transdermal Exelon In Mild-to-moderate Alzheimer's disease (OPTIMA), a double-blind trial comparing 13.3 and 9.5 mg/24 h rivastigmine patch in patients with AD demonstrating functional and cognitive decline with 9.5 mg/24 h patch. Efficacy on Alzheimer's disease Cooperative Study-instrumental ADL (ADCS-IADL) items, higher level function (HLF), and autonomy factors was assessed...
September 2013: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/23647369/real-life-effectiveness-and-tolerability-of-the-rivastigmine-transdermal-patch-in-patients-with-mild-to-moderate-alzheimer-s-disease-the-embrace-study
#15
MULTICENTER STUDY
Serge Gauthier, Alain Robillard, Sharon Cohen, Sandra Black, John Sampalis, Diane Colizza, Frederica de Takacsy, Robyn Schecter
OBJECTIVE: To assess the real-life effectiveness and tolerability of the rivastigmine transdermal patch in patients with mild-to-moderate Alzheimer's disease (AD) in Canada. RESEARCH DESIGN AND METHODS: Eighteen-month observational, prospective, multi-center, open-label study conducted on AD patients with Standardized Mini-Mental State Examination (SMMSE) score of 10-26 and Global Deterioration Scale (GDS) score of 4-6. Patients were treated with the rivastigmine transdermal patch (Exelon patch*) 5 cm² (4...
August 2013: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/23621892/the-impact-of-medicare-prescription-drug-coverage-on-the-use-of-antidementia-drugs
#16
Nicole R Fowler, Yi-Fan Chen, Christiana A Thurton, Aiju Men, Eric G Rodriguez, Julie M Donohue
BACKGROUND: Cholinesterase inhibitors and memantine are prescribed to slow the progression dementia. Although the efficacy of these drugs has been demonstrated, their effectiveness, from the perspective of patients and caregivers, has been questioned. Little is known about whether the demand for cholinesterase inhibitors and memantine are sensitive to out-of-pocket cost. Using the 2006 implementation of Medicare Part D as a natural experiment, this study examines the impact of changes in drug coverage on use of cholinesterase inhibitors and memantine by comparing use before and after Medicare Part D implementation among older adults who did and did not experience a change in coverage...
2013: BMC Geriatrics
https://www.readbyqxmd.com/read/22663954/a-fatal-outcome-after-unintentional-overdosing-of-rivastigmine-patches
#17
Henrik Lövborg, Anna K Jönsson, Staffan Hägg
BACKGROUND: Rivastigmine is an acetylcholine esterase inhibitor used in the treatment of dementia. Patches with rivastigmine for transdermal delivery have been used to increase compliance and to reduce side effects. CASE REPORT: We describe an 87-year old male with dementia treated with multiple rivastigmine patches (Exelon 9,5 mg/24 h) who developed nausea, vomiting and renal failure with disturbed electrolytes resulting in death. The symptoms occurred after six rivastigmine patches had concomitantly been erroneously applied by health care personnel on two consecutive days...
February 2012: Current Drug Safety
https://www.readbyqxmd.com/read/22163243/pharmacogenetic-study-on-the-effect-of-rivastigmine-on-ps2-and-apoe-genes-in-iranian-alzheimer-patients
#18
M Zamani, M Mehri, A Kollaee, P Yenki, M Ghaffarpor, M H Harirchian, M Shahbazi
BACKGROUND/AIMS: Alzheimer disease (AD) is a complex and genetically heterogeneous disorder, and certain genes such as PS2 and APOE4 contribute to the development of AD. Due to its heterogeneity, AD-predisposing genes could vary in different populations. Moreover, not all AD patients will respond to the same therapy. We specifically investigated the effect ofrivastigmine (Exelon) on PS2 and APOE genes in Iranian AD patients. METHODS: A total of 100 AD patients, 67 patients with sporadic AD (SAD) and 33 patients with familial AD (FAD), receiving rivastigmine therapy and 100 healthy controls were studied...
January 2011: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/22009228/rivastigmine-in-alzheimer-s-disease-and-parkinson-s-disease-dementia-an-adas-cog-factor-analysis
#19
Daniel Weintraub, Monique Somogyi, Xiangyi Meng
Rivastigmine treatment is associated with significant improvements on the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-cog) in patients with mild-to-moderate Alzheimer's disease (AD) and Parkinson's disease dementia (PDD). Both AD and PDD are purported to have different profiles of cognitive impairment, which may respond differentially to rivastigmine treatment. This was a retrospective analysis of 3 randomized, double-blind, rivastigmine trial databases (Investigation of transDermal Exelon in ALzheimer's disease [IDEAL; AD], EXelon in PaRkinson's disEaSe dementia Study [EXPRESS; PDD], and Alzheimer's Disease with ENA 713 [ADENA; AD])...
September 2011: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/21711064/rivastigmine-transdermal-patch-a-review-of-its-use-in-the-management-of-dementia-of-the-alzheimer-s-type
#20
REVIEW
Sohita Dhillon
Rivastigmine, a cholinesterase inhibitor, is available as a transdermal patch (Exelon(®) patch, Rivastach(®) patch, Prometax(®) patch) for the treatment of mild to moderate Alzheimer's disease. Rivastigmine transdermal patch was effective, in terms of improving cognitive and global function, and generally well tolerated in patients with mild to moderate dementia of the Alzheimer's type in a large, well designed trial. Most adverse events associated with rivastigmine patch were mild to moderate in severity, with the patch generally better tolerated than oral rivastigmine, especially in terms of cholinergic gastrointestinal adverse events...
June 18, 2011: Drugs
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