2. Anti cholinesterase

Anticholinesterases are a class of drugs that decrease breakdown of acetylcholine (a chemical messenger in the brain) and can be used in conditions whereby there is an apparent lack of this messenger transmission such as in Alzheimer’s disease.
. By blocking this enzyme the breakdown of acetylcholine, released by the remaining healthy brain cells, is slowed down leaving more chemical messengers available to support normal brain function.
The anticholinesterases are associated with prominent gastrointestinal adverse effects, particularly anorexia, nausea and vomiting.
Anticholinesterases may slow the heart; administration with other drugs which can cause this may increase the risk of bradycardia (very low heart rate) and hypotension (very low blood pressure); heart rate and BP may be monitored.
Anticholinesterases may slow the heart; administration with other drugs which can cause this may increase the risk of bradycardia (very low heart rate) and hypotension (very low blood pressure); heart rate and BP may be monitored.
Care should be taken when using these medications in patients with:
• Asthma and chronic obstructive airways disease – may increase shortness of breath.
• Cardiac conduction abnormalities – anticholinesterases can slow the heart
• Peptic ulcer – Because of their pharmacological action, cholinesterase inhibitors may be expected to increase gastric acid secretion.
• Severe renal impairment – may require individual dose titration.

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