Nuspojave antidementiva u liječenju pacijenata s Alzheimerovom demencijom

professional thesis

• Author: Petar Vehtersbach-Stojan
• Mentor: Miroslav Herceg (mentor)
• Committee member: Iva Mucalo (predsjednik povjerenstva)
• Committee member: Miroslav Herceg (član povjerenstva)
• Committee member: Vesna Bačić Vrca (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2021-09-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract

Cilj istraživanja: Cilj ovog rada je utvrditi podnošljivost i sigurnost lijekova za liječenje
Alzheimerove demencije, posebice iz razloga što je ova terapija uglavnom rezervirana za
stariju populaciju, odnosno rizičnu skupinu pacijenata često povezanu s mutimorbiditetima i
polifarmacijom, te se osvrnuti na važnost uloge koju ljekarnici, kao najdostupniji zdravstveni
djelatnici, mogu imati u liječenju Alzheimerove demencije i primjeni antidementiva.
Ispitanici i metode: U tu svrhu... More napravljen je sustavni i retrospektivni pregled znanstvene i
stručne literature te su pretražene trenutno važeće terapijske smjernice, publikacije stručnih
udruga i institucija, baza lijekova Agencije za lijekove i medicinske proizvode te drugi
raspoloživi izvori.
Rezultati: Najčešće nuspojave inhibitora acetilkolinesteraze su gastrointestinalne prirode te
uključuju mučninu, povraćanje, gubitak težine i proljev. Rivastigmin je pokazao najveću
učestalost nuspojava među njima, dok je donepezil povezan s najnižom stopom nuspojava.
Uglavnom se javljaju na početku terapije te su blage i često prolazne. Intenzivnije nuspojave
javljaju se primjenom većih doza te su često povezane s neispravnom inicijalnom titracijom
lijekova. Nuspojave memantina su relativno rijetke te se dosta dobro podnose, a najčešće
uključuju konstipaciju, vrtoglavicu, glavobolju i zbunjenost. Pokazalo se da su i one blagog i
prolaznog karaktera.
Zaključak: Identifikacijom najčešćih nuspojava svakog od odobrenih lijekova za liječenje
Alzheimerove demencije, uključujući donepezil, rivastigmin i memantin, pokazalo se da su
nuspojave ovih lijekova relativno rijetke te blagog i prolaznog karaktera pa možemo zaključiti
da se antidementivi općenito dobro podnose. Poboljšanje kvalitete života bolesnika oboljelih
od Alzheimerove demencije i njihovih njegovatelja je od iznimne važnosti, stoga ljekarnici,
kao najdostupniji zdravstveni djelatnici koji su često u kontaktu s ovim pacijentima i/ili
njihovim njegovateljima, moraju imati adekvatna znanja da mogu prepoznati postojeće i
potencijalne terapijske probleme, uključujući i nuspojave antidementiva, te svojom
intervencijom omogućiti sigurnu i učinkovitu farmakoterapiju. Less

Abstract (english)

Aim: The aim of this paper is to determine the tolerability and safety of treatment for
Alzheimer's dementia, especially because this therapy is mainly reserved for the elderly
population, ie the risk group of patients often associated with multimorbidities and
polypharmacy, and to look at the importance of the role that pharmacists, as the most
accessible health professionals, can play in the treatment of Alzheimer’s dementia and the use
of antidementia drugs.
Subjects and... More method: For the purposes of this research, a systematic and retrospective
review of scientific and professional literature was made and the currently valid therapeutic
guidelines, publications of professional associations and institutions, the drug database of the
Agency for Medicinal Products and Medical Devices and other available sources were
searched.
Results: The most common side effects of acetylcholinesterase inhibitors are gastrointestinal
in nature and include nausea, vomiting, weight loss and diarrhea. Rivastigmine showed the
highest frequency of side effects among them, while donepezil was associated with the lowest
rate of side effects. They usually occur at the beginning of therapy and are mild and often
transient. More intense side effects occur at higher doses and are often associated with
incorrect initial drug titration. Side effects of memantine are relatively rare and well tolerated,
and most commonly include constipation, dizziness, headache, and confusion. It turns out that
they are also mild and transient.
Conclusion: The identification of the most common side effects of each of the approved
drugs for the treatment of Alzheimer's dementia, including donepezil, rivastigmine and
memantine, showed that the side effects of these drugs are relatively rare and mild and
transient, so we can conclude that antidementia drugs are generally well tolerated. Improving
the quality of life of patients with Alzheimer's dementia and their carers is extremely
important, so pharmacists, as the most accessible health professionals who are often in contact
with these patients and / or their carers, must have adequate knowledge to identify existing
and potential therapeutic problems, including side effects of antidementia drugs, and make
interventions to provide safe and effective pharmacotherapy. Less

• Keywords: Alzheimerova demencija; Alzheimerova bolest; antidementivi; terapijski problemi; nuspojave lijekova; uloga ljekarnika
• Keywords (english): Alzheimer’s dementia; Alzheimer's disease; antidementia drugs; therapeutic problems; adverse drug reactions; pharmacists' role
• Language: croatian
• URN:NBN: urn:nbn:hr:163:901613
• Study programme: Title: Clinical pharmacy; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/sveučilišna magistra kliničke farmacije (sveučilišni/a magistar/sveučilišna magistra kliničke farmacije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-17 09:59:38