Abstract

Alzheimer’s disease is a chronic, multifactorial, and irreversible condition characterized by atrophy beginning in the entorhinal cortex and hippocampus, followed by the cerebral cortex. Clinically, the patient experiences a gradual cognitive decline, losing language, reasoning, and social behavior skills. Treatment involves acetylcholinesterase inhibitors (Donepezil, Galantamine, and Rivastigmine) or NMDA receptor antagonists (Memantine). The study described the pharmacodynamic and pharmacokinetic aspects of the main drugs, analyzing absorption, distribution, metabolism, excretion, adverse reactions, and drug interactions from articles in the BVS, Scielo, and Pubmed databases. Pharmacokinetic results show that Memantine is absorbed in 9-12 hours, with a half-life of 60-80 hours; Rivastigmine has rapid absorption, crossing the blood-brain barrier; Galantamine is absorbed from the gastrointestinal tract and metabolized in the liver. Donepezil has high bioavailability, a 70- hour half-life, and is metabolized in the liver. All are excreted by the kidneys. Regarding drug interactions, Donepezil increases the risk of seizures when combined with Tramadol or Bupropion; Galantamine is inhibited by drugs like Ketoconazole, increasing side effects; Memantine interacts with Acetazolamide and other drugs, increasing the risk of neuropsychiatric effects; Rivastigmine can cause bradycardia when combined with betablockers and enhances the effects of muscle relaxants. Adverse reactions include dizziness and diarrhea (Memantine), nausea (Rivastigmine), bradycardia (Galantamine), and weight loss (Donepezil). In conclusion, Alzheimer’s treatment, while not curative, improves the patient’s quality of life and slows the decline in social and cognitive abilities.

Keywords

rivastigmine, donepezil, galantamine, memantine, Alzheimer’s disease.