Potential drug–drug interactions in Alzheimer patients with behavioral symptoms

Potential drug–drug interactions in Alzheimer patients with behavioral symptoms

Giuseppe Pasqualetti, Sara Tognini, Valeria Calsolaro, Antonio Polini, Fabio Monzani Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Abstract: The use of multi drug regimens among the elderly population has increased tremendously over the last decad...

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Autores principales: Pasqualetti G, Tognini S, Calsolaro V, Polini A, Monzani F
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2015
Materias:
AChEIs
Alzheimer
antipsychotic
drug-drug interaction
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/2484cc546ad6445195f2d4a7576a8d3d
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spelling oai:doaj.org-article:2484cc546ad6445195f2d4a7576a8d3d2021-12-02T07:15:27ZPotential drug–drug interactions in Alzheimer patients with behavioral symptoms1178-1998https://doaj.org/article/2484cc546ad6445195f2d4a7576a8d3d2015-09-01T00:00:00Zhttps://www.dovepress.com/potential-drugndashdrug-interactions-in-alzheimer-patients-with-behavi-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Giuseppe Pasqualetti, Sara Tognini, Valeria Calsolaro, Antonio Polini, Fabio Monzani Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Abstract: The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug–drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug–drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer’s disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug–drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms. Keywords: AChEIs, Alzheimer, antipsychotic, drug–drug interactionPasqualetti GTognini SCalsolaro VPolini AMonzani FDove Medical PressarticleAChEIsAlzheimerantipsychoticdrug-drug interactionGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 10, Pp 1457-1466 (2015)
institution DOAJ
collection DOAJ
language EN
topic AChEIs
Alzheimer
antipsychotic
drug-drug interaction
Geriatrics
RC952-954.6
spellingShingle AChEIs
Alzheimer
antipsychotic
drug-drug interaction
Geriatrics
RC952-954.6
Pasqualetti G
Tognini S
Calsolaro V
Polini A
Monzani F
Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
description Giuseppe Pasqualetti, Sara Tognini, Valeria Calsolaro, Antonio Polini, Fabio Monzani Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Abstract: The use of multi drug regimens among the elderly population has increased tremendously over the last decade although the benefits of medications are always accompanied by potential harm, even when prescribed at recommended doses. The elderly populations are particularly at an increased risk of adverse drug reactions considering comorbidity, poly-therapy, physiological changes affecting the pharmacokinetics and pharmacodynamics of many drugs and, in some cases, poor compliance due to cognitive impairment and/or depression. In this setting, drug–drug interaction may represent a serious and even life-threatening clinical condition. Moreover, the inability to distinguish drug-induced symptoms from a definitive medical diagnosis often results in addition of yet another drug to treat the symptoms, which in turn increases drug–drug interactions. Cognitive enhancers, including acetylcholinesterase inhibitors and memantine, are the most widely prescribed agents for Alzheimer’s disease (AD) patients. Behavioral and psychological symptoms of dementia, including psychotic symptoms and behavioral disorders, represent noncognitive disturbances frequently observed in AD patients. Antipsychotic drugs are at high risk of adverse events, even at modest doses, and may interfere with the progression of cognitive impairment and interact with several drugs including anti-arrhythmics and acetylcholinesterase inhibitors. Other medications often used in AD patients are represented by anxiolytic, like benzodiazepine, or antidepressant agents. These agents also might interfere with other concomitant drugs through both pharmacokinetic and pharmacodynamic mechanisms. In this review we focus on the most frequent drug–drug interactions, potentially harmful, in AD patients with behavioral symptoms considering both physiological and pathological changes in AD patients, and potential pharmacodynamic/pharmacokinetic drug interaction mechanisms. Keywords: AChEIs, Alzheimer, antipsychotic, drug–drug interaction
format article
author Pasqualetti G
Tognini S
Calsolaro V
Polini A
Monzani F
author_facet Pasqualetti G
Tognini S
Calsolaro V
Polini A
Monzani F
author_sort Pasqualetti G
title Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
title_short Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
title_full Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
title_fullStr Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
title_full_unstemmed Potential drug–drug interactions in Alzheimer patients with behavioral symptoms
title_sort potential drug–drug interactions in alzheimer patients with behavioral symptoms
publisher Dove Medical Press
publishDate 2015
url https://doaj.org/article/2484cc546ad6445195f2d4a7576a8d3d
work_keys_str_mv AT pasqualettig potentialdrugndashdruginteractionsinalzheimerpatientswithbehavioralsymptoms
AT togninis potentialdrugndashdruginteractionsinalzheimerpatientswithbehavioralsymptoms
AT calsolarov potentialdrugndashdruginteractionsinalzheimerpatientswithbehavioralsymptoms
AT polinia potentialdrugndashdruginteractionsinalzheimerpatientswithbehavioralsymptoms
AT monzanif potentialdrugndashdruginteractionsinalzheimerpatientswithbehavioralsymptoms
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