It is metabolized by the liver and undergo extensive

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It is metabolized by the liver and undergo extensive first-pass metabolism. The elimination half-life of cholinesterase inhibitors in the elderly is almost twice as long as that in young adults (Shigeta & Homma, 2001). The longer half-life in the elderly may be attributed to the increase in the steady state volume of distribution throughout the whole body, since drug clearance at steady state is similar in the elderly and the young. No dosage adjustment is necessary in the elderly. Memantine is well absorbed after oral administration and has linear pharmacokinetics over the therapeutic dose range. It is excreted predominantly in the urine, unchanged, and has a terminal elimination half-life of about 60-80 hours. The pharmacokinetics of Memantine in young and elderly patients are similar. Cholinesterase inhibitors may interfere with the effects of anticholinergic agents, and so should be avoided in patients with dementia if possible; otherwise consideration should be taken when prescribing medications. Measures to Reducing Negative Effects Medications for the elderly need to be initiated at doses lower than those for adults; and when dose increases are necessary, they should be lower in dose and slower in rate than for adults; behavioral conditions such as depression, anxiety, psychosis and agitation should be evaluated in the elderly and if present, properly treated when cause is identified. Evaluations of the elderly should include a comprehensive review of all drugs being taken, including those that are prescribed, and those taken OTC and herbals. Also, lab work such liver panel and comprehensive metabolic panel should be done. Finally, decreasing doses of or eliminating medications can be more effective than increasing doses or adding medication when treating the elderly.References Alzheimer’s Association (2017). What is Dementia? Retrieved from
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Arcangelo, V. P., & Peterson, A. M. (2013). Pharmacotherapeutics for advanced practice: A practical approach (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins . National Institute on Aging (2013). The Dementias: Hope through Research. Retrieved from National Institute of Neurological Disorders and Stroke (2013). Dementia: Hope through Research. Retrieved from - Education/Hope-Through-Research/Dementia-Hope-Through-Research Shigeta, M. & Homma, A. (2001). Donepezil for Alzheimer’s Disease: Pharmacodynamic, Pharmacokinetic, and Clinical Profiles. Retrieved from - 3458.2001.tb00204.x/asset/j.1527- 3458.2001.tb00204.x.pdf;jsessionid=E74B319DB10E33096CEEE12867B4673A.f01 t04?v=1&t=j4dbm56y&s=3fcb0eb6d49d638ccc042bb79d5619462efa0cae Thanks for posting such valuable information, According to Laureate Education, Inc.
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