Galantamine - Revision history

Zeki at 01:55, 7 November 2024

2024-11-07T01:55:45Z

← Older revision		Revision as of 21:55, 6 November 2024
Line 5:		Line 5:
	'''Drug class: [[:Category: Acetylcholinesterase inhibitor \| Acetylcholinesterase Inhibitor]]'''		'''Drug class: [[:Category: Acetylcholinesterase inhibitor \| Acetylcholinesterase Inhibitor]]'''

	'''Galantamine (REMINYL)'''(中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.		'''Galantamine (REMINYL)''' (中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.
	==Common Strengths of Galantamine==		==Common Strengths of Galantamine==
	*Extended-Release Capsules: 8 mg, 16 mg, 24 mg.		*Extended-Release Capsules: 8 mg, 16 mg, 24 mg.

Zeki at 01:55, 7 November 2024

2024-11-07T01:55:17Z

← Older revision		Revision as of 21:55, 6 November 2024
Line 65:		Line 65:

	==Drug Precautions==		==Drug Precautions==
	~~====Monitoring====~~		'''Pregnancy
	*acetylcholinesterase inhibitor may increase gastric acid secretion, so patients should be monitored closely for GI bleeding, especially those receiving concurrent NSAID drugs.
	*check body weight regularly
	*monitor the cognitive, global functions, and ADL activities
	*monitor the sleeping quality

	~~===Drug interaction===~~		It is generally advised that galantamine should be avoided during pregnancy unless necessary due to potential risk to fetal development.
	~~Hepatic metabolism of donepezil via the cytochrome P450 will~~ be ~~affected by drugs that inhibit the isoenzyme CYP3A4 and CYP2D6~~
	~~Interactions do not generally apply~~ to ~~steroid used for topical action including inhalation, unless specified~~.

	~~{\|class="wikitable"~~		'''Breastfeeding
	~~!Drugs given with donepezil~~
	~~!\|Potential Effect~~
	\|-
	~~!style="text-align: left"\| CYP2D6 inhibitors:~~
	~~SSRI, such as Paroxetine,~~
	~~Quinidine,~~
	~~Amitriptyline~~
	~~\|May increase plasma-donepezil concentration, increasing the risk of severe adverse reactions.~~
	\|-
	~~!style="text-align: left"\| CYP3A4 inhibitors:~~
	~~Erythromycin, Itraconazole, Ketoconazole~~
	~~\|May increase plasma-donepezil concentration, increasing the risk of severe adverse reactions~~
	\|-
	~~!style="text-align: left"\| CYP3A4 inducers & CYP2D6 inducers:~~
	~~Rifampicin, Phenytoin, Carbamazepine~~
	~~\|May reduce plasma-donepezil concentration~~
	\|}

	~~===Caution===~~		Du to the lack of data, galantamine is typically not recommended for breastfeeding women unless the benefits outweigh the risks.
	*Cardiovascular conduction disorders such as sick-sinus syndrome
	*Susceptibility to ~~peptic ulcers~~		'''Children and Elderly
	*Asthma, ~~chronic obstructive pulmonary disease~~
	*People who have a predisposition to seizures
	*Concomitant antipsychotic treatment – increased risk of neuroleptic malignant syndrome

	~~===Contraindications===~~		Galantamine is generally not recommended for children due to limited safety data. In elderly patients, dosing should be cautions due to increased sensitivity and potential for side effects.
	patients ~~with severe impairment (creatinine clearance less than 9ml/minute~~.
	~~Patients with known hypersensitivity to galantamine hydrobromide~~

	~~===~~Hepatic ~~impairment===~~		'''Hepatic Impairment
	*no dose adjustment of galantamine is necessary in mild hepatic impairment.		*No dose adjustment of galantamine is necessary in mild hepatic impairment.
	*For immediate-release tablet, in moderate impairment, initially 4mg once daily, preferably in the morning, for at least one week, then 4 mg twice daily for at least 4 weeks. Maximum 8 mg twice daily. Avoid in severe impairment		*For immediate-release tablet, in moderate impairment, initially 4mg once daily, preferably in the morning, for at least one week, then 4 mg twice daily for at least 4 weeks. Maximum 8 mg twice daily. Avoid in severe impairment
	*For modified-release capsules in moderate impairment, initially 8 mg on alternate days, preferably in the morning for 1 week, then 8 mg once daily for 4 weeks. Maximum 16 mg daily. Avoid in severe impairment		*For modified-release capsules in moderate impairment, initially 8 mg on alternate days, preferably in the morning for 1 week, then 8 mg once daily for 4 weeks. Maximum 16 mg daily. Avoid in severe impairment

	~~===~~Renal ~~impairment===~~		'''Renal Impairment
	*No dose adjustment is necessary for galantamine in mild or moderate renal impairment.		*No dose adjustment is necessary for galantamine in mild or moderate renal impairment.
	*Avoid if eGFR less than 9ml/minute/1.73m2		*Avoid if eGFR less than 9ml/minute/1.73m2

	~~===~~Effects on ability to drive and use machinery~~===~~		'''Drug Monitoring Items

			Monitoring should include:
			*Heart rate and rhythm (due to potential bradycardia)
			*Weight monitoring: galantamine may contribute to weight loss
			*Renal function (especially in those with kidney disease)
			*Signs of gastrointestinal distress or allergic reactions.
			*Cognitive assessments to evaluate the effectiveness of treatment and monitor for adverse effects

			'''Drug Interactions
			Galantamine may interact with:
			*Other cholinesterase inhibitors (increased risk of side effects)
			*Anticholinergic medications (may reduce effectiveness)
			*Medications affecting heart rhythm (increased risk of bradycardia)

			'''Caution
			*Cardiovascular conduction disorders such as sick-sinus syndrome
			*Susceptibility to peptic ulcers
			*Asthma, chronic obstructive pulmonary disease
			*People who have a predisposition to seizures
			*Concomitant antipsychotic treatment
			**Increased risk of neuroleptic malignant syndrome

			'''Contraindications
			*Patients with severe impairment (creatinine clearance less than 9 mL/minute)
			*Patients with known hypersensitivity to galantamine hydrobromide

			'''Effects on ability to drive and use machinery

	Donepezil can cause fatigue, dizziness and muscles, mainly when initiating or increasing the dose. The treating doctor should routinely evaluate the ability of patients on donepezil to continue driving or operating complex machines.		Donepezil can cause fatigue, dizziness and muscles, mainly when initiating or increasing the dose. The treating doctor should routinely evaluate the ability of patients on donepezil to continue driving or operating complex machines.

	==FAQ==		==FAQ==

	~~====~~ How ~~should Galantamine be taken~~?~~====~~		'''How Should I Take the Tablet?
	~~Galantamine comes in three forms: as 8mg and 12mg tablets; as Galatamine XL in 8mg, 16mg and 24mg prolonged release capsules; and as an oral solution 4mg/ml.~~
	~~Tablets and oral solution should be administered twice a day, preferably~~ with ~~morning and evening meals. Drink plenty of liquids~~ to ~~keep yourself hydrated~~.		Take galantamine with food to minimize gastrointestinal upset.

			'''What Should I Avoid While Taking?

	~~====What should I avoid while taking?====~~		Avoid alcohol and medications that can further lower heart rate on affect cognitive function without consulting your healthcare provider.
	Avoid ~~abruptly discontinue the medication~~.

	~~====~~ What ~~happen~~ if I ~~overdose~~?~~====~~		'''What Happens if I Miss a Dose?
	~~Contact your primary care doctor.~~
	~~If emergency situation, call 999~~

	~~==== What happen if I~~ miss a dose~~?====~~		If you miss a dose, take it as soon as you remember unless it is close to the time for your next dose. Do not double up on doses.
	~~Take~~ it as soon as you
	remember~~. If~~ it is ~~near~~ the time
	~~of the next dose, skip the missed~~
	~~dose. Take~~ your next dose ~~at the~~
	~~regular time~~. Do not double ~~the~~
	~~dose to catch~~ up.

Zeki: /* Drug Precautions */

2024-11-07T01:21:04Z

Drug Precautions

← Older revision		Revision as of 21:21, 6 November 2024
Line 65:		Line 65:

	==Drug Precautions==		==Drug Precautions==
	===Monitoring===		====Monitoring====
	*acetylcholinesterase inhibitor may increase gastric acid secretion, so patients should be monitored closely for GI bleeding, especially those receiving concurrent NSAID drugs.		*acetylcholinesterase inhibitor may increase gastric acid secretion, so patients should be monitored closely for GI bleeding, especially those receiving concurrent NSAID drugs.
	*check body weight regularly		*check body weight regularly

Zeki at 01:19, 7 November 2024

2024-11-07T01:19:41Z

← Older revision		Revision as of 21:19, 6 November 2024
Line 28:		Line 28:

	==Side Effects==		==Side Effects==
	~~Common side effects include~~		{\| class="wikitable"
	*Nausea and vomiting		!style="text-align: left"\| Frequency
	*difficulty sleeping		!Adverse reactions
	*aggression		\|-
	*Loss of appetite		\| rowspan="5" \| '''Common Side Effects
	*Diarrhoea		\| Nausea
	*Feeling tired		\|-
	*Muscle cramps		\| Vomiting
	~~These effects usually last 1 – 3 weeks and then lessen~~		\|-
			\| Diarrhea
	~~Serious side effects may include:~~		\|-
	*Abnormal heart rhythms		\| Dizziness
	*Difficulty emptying urine from the bladder		\|-
	*seizures		\| Loss of appetite
			\|-
	~~==Pharmacokinetics==~~		\| rowspan="5" \| '''Serious Side Effects
	{\| ~~class~~ = "~~wikitable~~"		\| Severe allergic reactions (e.g. rash, difficulty breathing)
	~~!style="text~~-~~align: left"\| Oral bioavailability~~		\|-
	\|~~Donepezil hydrochloride is rapidly and well absorbed from the gastrointestinal tract~~ with ~~an oral bioavailability of about 90%. Plasma protein binding is about 18%~~.		\| Slow heart rate, chest pain, or irregular heart rhythms, which could lead to fainting or cardiac arrest. Patients with pre-existing heart conditions should be monitored closely.
	\|-		\|-
	~~!style="text-align: left"~~\| ~~Onset of action~~		\| Seizures
	~~\|Peak plasma levels in about one hour after ingestion from immediate-release preparations; 4 to 5 hours after a dose of modified-release formulations~~
	\|-		\|-
	~~!style="text-align: left"~~\| ~~Metabolism~~		\| Urinary retention
	~~\|Partially metabolized by CYP2D6, CYP3A4~~
	\|-		\|-
	~~!style="text-align: left"~~\| ~~Elimination half-life~~		\| Gastrointestinal bleeding (symptoms such as tarry stools, or vomiting that resembles coffee grounds)
	~~\|7 to 8 hours~~
	\|}		\|}

	==Drug ~~Management~~==		==Pharmacokinetics==
			Galantamine has:
			*Absorption: Approximately 90% bioavailability.
			*Onset Time: Effects typically observed within an hour post-administration.
			*Time to Peak Concentration (T<sub>max</sub>): After oral administration, galantamine reaches peak plasma approximately 4 hours for extended-release formulations.
			*Metabolic Pathways: Approximately 75% of galantamine is metabolized in the liver primarily by cytochrome P450 enzyme CYP2D6 and CYP3A4.
			*Genetic Variability: There are genetic variations affecting metabolism, particularly involving CYP2D6. Poor metabolizers may experience higher plasma concentrations and prolonged effects of galantamine compared to extensive metabolizers.
			*Half-Life: The elimination half-life of galantamine ranges from about 7 to 8 hours, allowing for twice-daily dosing in clinical practice.

			==Drug Precautions==
	===Monitoring===		===Monitoring===
	*acetylcholinesterase inhibitor may increase gastric acid secretion, so patients should be monitored closely for GI bleeding, especially those receiving concurrent NSAID drugs.		*acetylcholinesterase inhibitor may increase gastric acid secretion, so patients should be monitored closely for GI bleeding, especially those receiving concurrent NSAID drugs.

Zeki at 01:00, 7 November 2024

2024-11-07T01:00:44Z

← Older revision		Revision as of 21:00, 6 November 2024
Line 1:		Line 1:
	[[Category: Drugs]] [[Category: Acetylcholinesterase ~~inhibiting drug]]~~		[[Category: Drugs]][[Category: Acetylcholinesterase inhibitor]]
	~~'''Galantamine Hydrobromide'''(中文: [[加蘭他敏~~]]~~) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.~~

	==Drug ~~name==~~		[[:Category: Antidementia Drug \| '''Antidementia Drug''']]
	{\| ~~class="wikitable"~~
	~~!Generic Name 藥名~~
	~~!HA Code 藥物代碼~~
	~~!Classification藥物分類~~
	\|-
	~~\|Galantamine HBR Prolonged Release Cap 8mg~~
	~~\|GALA04~~
	~~\|P1S1S3~~
	\|-
	~~\|Galantamine HBR Prolonged Release Cap 16mg~~
	~~\|GALA05~~
	~~\|P1S1S3~~
	\|-
	~~\|Galantamine HBR Prolonged Release Cap 24mg~~
	~~\|GALA06~~
	~~\|P1S1S3~~
	\|}

	==~~Mechanism~~ of ~~Action~~==		'''Drug class: [[:Category: Acetylcholinesterase inhibitor \| Acetylcholinesterase Inhibitor]]'''
	~~Acetylcholinesterase inhibiting drug~~
			'''Galantamine (REMINYL)'''(中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.
			==Common Strengths of Galantamine==
			*Extended-Release Capsules: 8 mg, 16 mg, 24 mg.

			==Drug Trade Names==
			*Reminyl Prolonged release (Extended Release)

	==~~Dosage~~==		==Drug Usage==
	~~{\|class="wikitable"~~		Galantamine is primarily prescribed for:
	~~!style="text-align~~: ~~left"\|By Oral~~		*Mild to moderate dementia associated with Alzheimer's disease.
	~~\|initially 4 mg twice daily for 4 weeks increased~~ to ~~8 mg twice daily for 4 weeks; maintenance 8-12 mg twice daily according to response~~ and ~~tolerance~~.		*Cognitive impairment in conditions like Down syndrome and vascular dementia.
	\|}

	~~A modified-release preparation~~ is ~~also available~~ for ~~once-daily use~~.		==Mechanism of Action==
			Galantamine act as an acetylcholinesterase inhibitor, preventing the breakdown of acetylcholine, thereby increasing the concentration of acetylcholine in the brain, which is crucial for memory and cognitive functions.

	~~Clinical benefit should be assessed on a regular basis.~~		==Route of Administration==
			Galantamine is administered orally in various forms:
			*Oral

	~~Reductions in dose may be necessary in patients with hepatic or renal impairment.~~		==Dosage==
			Initial: 8 mg/day; Maintenance: 16 to 24 mg/day

	==Side Effects==		==Side Effects==

Helen: /* Dosage */

2020-10-12T06:10:12Z

Dosage

← Older revision		Revision as of 02:10, 12 October 2020
Line 25:		Line 25:

	==Dosage==		==Dosage==
	By Oral: initially 4 mg twice daily for 4 weeks increased to 8 mg twice daily for 4 weeks; maintenance 8-12 mg twice daily according to response and tolerance.		{\|class="wikitable"
			!style="text-align: left"\|By Oral
			\|initially 4 mg twice daily for 4 weeks increased to 8 mg twice daily for 4 weeks; maintenance 8-12 mg twice daily according to response and tolerance.
			\|}

	A modified-release preparation is also available for once-daily use.		A modified-release preparation is also available for once-daily use.

	Clinical benefit should be assessed on a regular basis.		Clinical benefit should be assessed on a regular basis.

Helen at 06:10, 8 October 2020

2020-10-08T06:10:45Z

← Older revision		Revision as of 02:10, 8 October 2020
Line 1:		Line 1:
	[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]		[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]
	'''Galantamine Hydrobromide'''(中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.		'''Galantamine Hydrobromide'''(中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.

			==Drug name==
	{\| class="wikitable"		{\| class="wikitable"
	!Generic Name 藥名		!Generic Name 藥名

Helen at 06:09, 8 October 2020

2020-10-08T06:09:26Z

← Older revision		Revision as of 02:09, 8 October 2020
Line 1:		Line 1:
	[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]		[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]
	'''Galantamine Hydrobromide'''(中文: [[~~利凡斯的明~~]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.		'''Galantamine Hydrobromide'''(中文: [[加蘭他敏]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.
	{\| class="wikitable"		{\| class="wikitable"
	!Generic Name 藥名		!Generic Name 藥名

Helen at 06:07, 8 October 2020

2020-10-08T06:07:52Z

← Older revision		Revision as of 02:07, 8 October 2020
Line 1:		Line 1:
	[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]		[[Category: Drugs]] [[Category: Acetylcholinesterase inhibiting drug]]
	'''Galantamine Hydrobromide''' is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.		'''Galantamine Hydrobromide'''(中文: [[利凡斯的明]]) is a reversible inhibitor of acetylcholinesterase. It also has an intrinsic action on nicotinic receptors. It is used for the treatment of mild to moderate dementia in Alzheimer’s disease.
	{\| class="wikitable"		{\| class="wikitable"
	!Generic Name 藥名		!Generic Name 藥名

Ctol2: /* Pharmacokinetics */

2020-09-30T10:15:08Z

Pharmacokinetics

← Older revision		Revision as of 06:15, 30 September 2020
Line 57:		Line 57:
	\|Partially metabolized by CYP2D6, CYP3A4		\|Partially metabolized by CYP2D6, CYP3A4
	\|-		\|-
	!Elimination half-life		!style="text-align: left"\| Elimination half-life
	\|7 to 8 hours		\|7 to 8 hours
	\|}		\|}