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Anticholinesterase Agents: Poisoning and Treatment01:26

Anticholinesterase Agents: Poisoning and Treatment

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Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.     
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
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Alzheimer's Disease: Treatment01:22

Alzheimer's Disease: Treatment

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Alzheimer's Disease (AD), a neurodegenerative disorder, is pathologically identified by amyloid plaques and neurofibrillary tangles composed of tau protein. AD pharmacotherapy aims to manage cognitive symptoms, delay disease progression, and treat behavioral symptoms. The treatment is primarily symptomatic and palliative, with no definitive disease-modifying therapy available. Cholinesterase inhibitors, including donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne), are...
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Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance01:23

Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance

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The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

111
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists01:30

Cognitive Enhancers: Cholinesterase Inhibitors and NMDA Receptor Antagonists

366
Cognitive enhancers, also known as "smart drugs," are substances used to enhance memory, mental alertness, and concentration. These can be natural or synthetic and improve cognition in conditions like Alzheimer's disease (AD) and other neurodegenerative diseases. Some common examples include caffeine, amphetamines, methylphenidate, modafinil, arecoline, donepezil, vortioxetine, and piracetam. These enhancers work on the principle of synaptic plasticity and altered circuit function.
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Related Experiment Video

Updated: Nov 24, 2025

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development
07:02

A Computerized Test Battery to Study Pharmacodynamic Effects on the Central Nervous System of Cholinergic Drugs in Early Phase Drug Development

Published on: February 11, 2019

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Suspected donepezil toxicity: A case report.

Carmen Gust1, Nicholas Pugliese2, Gretchen Stern3

  • 1Department of Pharmacy Services Indiana University Health, Methodist Hospital Indianapolis Indiana.

Clinical Case Reports
|December 28, 2020
PubMed
Summary
This summary is machine-generated.

Donepezil toxicity mimics other conditions like beta-blocker overdose, causing confusion and bradycardia. Always consider all medications when diagnosing toxicity.

Keywords:
Donepezilbeta‐blockertoxicity

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Area of Science:

  • Toxicology
  • Pharmacology
  • Internal Medicine

Background:

  • Donepezil, an acetylcholinesterase inhibitor, is commonly prescribed for Alzheimer's disease.
  • Overdoses or toxic exposures can lead to significant clinical manifestations.
  • Differential diagnosis in toxicology requires careful consideration of drug classes.

Observation:

  • Donepezil toxicity can present with symptoms overlapping those of beta-blocker overdose and colitis.
  • Key symptoms include confusion, diaphoresis (excessive sweating), and bradycardia (slow heart rate).

Findings:

  • The clinical presentation of donepezil toxicity requires careful differential diagnosis.
  • Overlap in symptoms necessitates a thorough review of all active medications.

Implications:

  • Clinicians must consider donepezil when evaluating patients with unexplained confusion and bradycardia.
  • Comprehensive medication history is crucial for accurate diagnosis and management of toxic exposures.