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(Dawn-epp-uh-zill)
Aricept
Class: Reversible cholinesterase inhibitor

 Action Increases acetylcholine by inhibiting acetylcholinesterase, thereby increasing cholinergic function.

 Indications Treatment of mild-to-moderate dementia of the Alzheimer’s type.

 Contraindications Hypersensitivity to donepezil or piperidine derivatives.

 Route/Dosage

ADULTS: PO 5 mg once daily. May increase to 10 mg qd after 4 to 6 wks.

 Interactions

Anticholinergic drugs: Possible reduction of anticholinergic effects. Cholinesterase inhibitors/Cholinomimetics: Synergistic effects may occur.

 Lab Test Interferences None well documented.

 Adverse Reactions

CV: Syncope; chest pain; hypertension; hypotension; vasodilation; atrial fibrillation; hot flashes; delusions; tremor; irritability; paresthesia; aggression; vertigo; ataxia; increased libido; restlessness; abnormal crying; nervousness; aphasia. CNS: Depression; abnormal dreams; somnolence; insomnia; fatigue; dizziness. DERM: Diaphoresis; urticaria; pruritis. EENT: Cataract; eye irritation; blurred vision. GI: Nausea; diarrhea; vomiting; anorexia; fecal incontinence; GI bleeding; bloating; epigastric pain. GU: Frequent urination; urinary incontinence; nocturia. HEMA: Anemia; thrombocytopenia; eosinophilia. META: Weight decrease; dehydration. RESP Dyspnea; sore throat; bronchitis. OTHER: Muscle cramps; arthritis; tooth pain.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Concomitant medical conditions: Increases cholinergic activity and therefore can affect other organ systems, possibly leading to bradycardia, bladder outflow obstruction, increased gastric acid secretion, or bronchoconstriction. Use drug with caution in patients susceptible to these effects.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • Available only in PO form at this time.
  • Administer as a single dose daily, in the evening, just before retiring.
  • Store at room temperature (59° to 86°F).
  • May be administered with or without food.

 Assessment/Interventions

  • Obtain complete patient history, including drug history and any known allergies. Note current cardiac, GI, GU, or pulmonary conditions.
  • Evaluate patient’s mental status and function prior to initiation of therapy.
  • Monitor patient for signs of improvement after therapy is started.
  • Monitor patient for side effects of drug. Report any to physician.
OVERDOSAGE: SIGNS & SYMPTOMS
  Cholinergic crisis (eg, severe nausea, vomiting, salivation, sweating, bradycardia, hypotension, respiratory depression, muscle weakness, collapse, convulsions).

 Patient/Family Education

  • Advise patient, family, or caregivers that this drug does not alter the Alzheimer’s process and that the effectiveness of the medication may lessen over time.
  • Advise patient’s family or caregivers that side effects tend to diminish as therapy continues.
  • Advise patient, family, or caregivers to not discontinue the drug or change the dose unless advised to do so by the physician.

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