Pharmacotherapeutic Approach to the Treatment of Alzheimer Disease

摘要: A systematic attempt to develop drugs treat Alzheimer disease (AD) was initiated on a large scale 10 years ago following publication in the New England Journal of Medicine first successful results obtained with Cholinesterase inhibitor (ChEI) tacrine (THA, tetrahydroaminoacridine) by Summers et al. [1]. Tacrine is not ChEI be tested clinically for treating AD. Numerous studies [2] had been performed previously, particularly USA, small groups patients, physostigmine (physo) alone or combination lecithin. Physostigmine, like tacrine, showed definite but only short-lasting improvements cognitive symptoms (attention, concentration, memory), which were accompanied severe peripheral and central cholinergic side effects. These consisted mainly gastrointestinal drowsiness, case also liver toxicity. It soon realized that spite this encouraging result, both physo far from an ideal drug AD treatment. However, represent important milestones therapy, as they supported time patient pharmacological hypothesis formulated experimental animal [3, 4, 5, 6] treatment improving function system through increase brain acetylcholine (ACh) would improve cognition patients. Targeting therapy does necessarily limit itself use ChEI. Two other classes might valid alternatives, such nicotinic muscarinic agonists (Fig. 1).