A 72-year-old woman with Alzheimer's disease and comorbid Parkinson's disease dementia is started on a cholinesterase inhibitor. Which drug is a pseudo-irreversible inhibitor and is approved for both Alzheimer's dementia and Parkinson's disease dementia?
- A Donepezil
- B Rivastigmine ✓
- C Galantamine
- D Memantine
Correct answer: B. Rivastigmine
Explanation
Rivastigmine is a pseudo-irreversible inhibitor of both acetylcholinesterase and butyrylcholinesterase, and it is approved for both Alzheimer's and Parkinson's disease dementia. Donepezil and galantamine are reversible inhibitors approved only for Alzheimer's disease. Memantine is an NMDA receptor antagonist used for moderate-to-severe Alzheimer's, and it does not act on the cholinesterase enzyme.
Reference: Katzung Basic & Clinical Pharmacology, 15th ed.
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