Selected anticholinesterases and precautions for their use
THE CONTEXT
The passage describes agents used for Alzheimer's disease, organophosphate miotics, and conditions that restrict anticholinesterase use.
Agents for Alzheimer's disease
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Donepezil produces cognitive and behavioural improvement in Alzheimer's disease. It is long acting and suitable for once-daily administration.
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Galantamine is a natural alkaloid inhibitor of cerebral acetylcholinesterase with additional weak agonistic activity at nicotinic receptors. It is used for symptomatic relief in Alzheimer's disease.
Organophosphate miotics
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Dyflos, identified as DFP, is a very potent and long-acting anticholinesterase that is now obsolete as a miotic.
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Echothiophate is a water-soluble organophosphate with a quaternary structure and was used as a long-acting miotic.
Contraindications and caution
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Anticholinesterases are contraindicated in sick sinus, atrioventricular conduction defects, and hypotensive states.
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They require cautious use in patients with peptic ulcer, hypertension, asthma, COPD, or seizures.