Alzheimer's disease: how to give and monitor tacrine therapy.
Up to one-third of patients with mild to moderate Alzheimer's disease may show improvement in cognitive function with tacrine, a centrally-acting, noncompetitive inhibitor of acetylcholinesterase. Candidates for tacrine must have a diagnosis of probable Alzheimer's dementia based on NINCDS-ADRDA or DSM-IV criteria and should have no history of liver disease. For patients receiving the drug, do follow-up cognitive testing with a sensitive measure such as the Alzheimer's Disease Assessment Scale. The most common adverse effects associated with tacrine therapy are elevated liver transaminases and gastrointestinal effects. Weekly blood tests are necessary to monitor liver function. A reliable caregiver is essential to ensure compliance with frequent dosing and weekly blood testing.
Woo
J K
JK
Department of Geriatrics and Adult Development, Mount Sinai School of Medicine, New York, USA.
Lantz
M S
MS
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D000544:Alzheimer Disease / Q000175:diagnosis / Q000188:drug therapy*; D056486:Chemical and Drug Induced Liver Injury; D000075202:Contraindications; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000201:enzymology; D008111:Liver Function Tests; D013619:Tacrine / Q000009:adverse effects / Q000627:therapeutic use*
D013619:Tacrine; D000410:Alanine Transaminase