galantamine hydrobromide

Razadyne, Razadyne ER, Reminyl (UK), Reminyl XL (CA) (UK)

Pharmacologic class: Cholinesterase inhibitor

Therapeutic class: Anti-Alzheimer's agent

Pregnancy risk category B

Action

Unclear. May reversibly inhibit acetylcholinesterase, increasing concentration of acetylcholine (necessary for nerve impulse transmission) in brain synapses.

Availability

Capsules (extended-release): 8 mg, 16 mg, 24 mg

Oral solution: 4 mg/ml

Tablets: 4 mg, 8 mg, 12 mg

Indications and dosages

➣ Mild to moderate dementia of Alzheimer's disease

Adults: Initially, 4 mg P.O. b.i.d. If patient tolerates dosage well after at least 4 weeks of therapy, increase to 8 mg P.O. b.i.d. May increase to 12 mg P.O. b.i.d. after at least 4 weeks at previous dosage. Recommended range is 16 to 24 mg daily in two divided doses. Or initially, 8 mg P.O. daily (Razadyne ER). If patient tolerates dosage after at least 4 weeks, increase to 16 mg P.O. daily. Further increase to 24 mg P.O. daily should be attempted after minimum of 4 weeks at 16 mg/day.

Dosage adjustment

• Moderate hepatic or renal impairment

Off-label uses

• Vascular dementia

Contraindications

• Hypersensitivity to drug

• Severe hepatic or renal impairment

• Pregnancy or breastfeeding

• Children

Precautions

Use cautiously in:

• asthma, chronic obstructive pulmonary disease, GI bleeding, moderate hepatic or renal impairment, Parkinson's disease, seizures.

Administration

• Before giving, make sure patient is well hydrated, to minimize GI upset.

• Give with morning and evening meals.

• Give with antiemetics as needed.

• Use pipette to add oral solution to beverage; have patient drink it right away.

Adverse reactions

CNS: depression, dizziness, headache, tremor, insomnia, drowsiness, fatigue, syncope

CV: bradycardia

EENT: rhinitis

GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia

GU: urinary tract infection, hematuria

Hematologic: anemia

Other: weight loss

Interactions

Drug-drug Anticholinergics: antagonism of anticholinergic activity

Cholinergics: synergistic effects

Cimetidine, erythromycin, ketoconazole, paroxetine: increased galantamine bioavailability

Patient monitoring

• Assess fluid intake and output to ensure adequate hydration, which helps reduce GI upset.

• Monitor cognitive status.

• Evaluate patient for cardiac conduction abnormalities. Assess pulse regularly for bradycardia.

• Observe for bleeding tendencies.

See Assess for depression and suicidal ideation.

Patient teaching

• Instruct caregiver in proper technique for using oral pipette.

• Teach caregiver how to measure patient's pulse. Tell him to report slow pulse right away.

• Recommend frequent, small servings of healthy food and adequate fluids to minimize GI upset.

See Tell patient or caregiver to watch for and report signs and symptoms of depression.

• Advise patient or caregiver to establish effective bedtime routine.

• Caution caregiver to prevent patient from performing hazardous activities until adverse reactions are known.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.

单词	galantamine hydrobromide
释义	DictionarySeegalantamine galantamine hydrobromide galantamine hydrobromide Razadyne, Razadyne ER, Reminyl (UK), Reminyl XL (CA) (UK) *Pharmacologic class:* Cholinesterase inhibitor *Therapeutic class:* Anti-Alzheimer's agent *Pregnancy risk category B* Action Unclear. May reversibly inhibit acetylcholinesterase, increasing concentration of acetylcholine (necessary for nerve impulse transmission) in brain synapses. Availability Capsules (extended-release): 8 mg, 16 mg, 24 mg Oral solution: 4 mg/ml Tablets: 4 mg, 8 mg, 12 mg Indications and dosages ➣ Mild to moderate dementia of Alzheimer's disease Adults: Initially, 4 mg P.O. b.i.d. If patient tolerates dosage well after at least 4 weeks of therapy, increase to 8 mg P.O. b.i.d. May increase to 12 mg P.O. b.i.d. after at least 4 weeks at previous dosage. Recommended range is 16 to 24 mg daily in two divided doses. Or initially, 8 mg P.O. daily (Razadyne ER). If patient tolerates dosage after at least 4 weeks, increase to 16 mg P.O. daily. Further increase to 24 mg P.O. daily should be attempted after minimum of 4 weeks at 16 mg/day. Dosage adjustment • Moderate hepatic or renal impairment Off-label uses • Vascular dementia Contraindications • Hypersensitivity to drug • Severe hepatic or renal impairment • Pregnancy or breastfeeding • Children Precautions Use cautiously in: • asthma, chronic obstructive pulmonary disease, GI bleeding, moderate hepatic or renal impairment, Parkinson's disease, seizures. Administration • Before giving, make sure patient is well hydrated, to minimize GI upset. • Give with morning and evening meals. • Give with antiemetics as needed. • Use pipette to add oral solution to beverage; have patient drink it right away. Adverse reactions CNS: depression, dizziness, headache, tremor, insomnia, drowsiness, fatigue, syncope CV: bradycardia EENT: rhinitis GI: nausea, vomiting, diarrhea, abdominal pain, dyspepsia, anorexia GU: urinary tract infection, hematuria Hematologic: anemia Other: weight loss Interactions Drug-drug Anticholinergics: antagonism of anticholinergic activity Cholinergics: synergistic effects Cimetidine, erythromycin, ketoconazole, paroxetine: increased galantamine bioavailability Patient monitoring • Assess fluid intake and output to ensure adequate hydration, which helps reduce GI upset. • Monitor cognitive status. • Evaluate patient for cardiac conduction abnormalities. Assess pulse regularly for bradycardia. • Observe for bleeding tendencies. See Assess for depression and suicidal ideation. Patient teaching • Instruct caregiver in proper technique for using oral pipette. • Teach caregiver how to measure patient's pulse. Tell him to report slow pulse right away. • Recommend frequent, small servings of healthy food and adequate fluids to minimize GI upset. See Tell patient or caregiver to watch for and report signs and symptoms of depression. • Advise patient or caregiver to establish effective bedtime routine. • Caution caregiver to prevent patient from performing hazardous activities until adverse reactions are known. • As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.
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