Donepezil

Excerpt

Donepezil hydrochloride, a piperidine derivative, is a centrally acting, rapid, and reversible acetylcholinesterase inhibitor primarily utilized for treating Alzheimer disease. Acetylcholinesterase is an enzyme that breaks down acetylcholine after its release from the presynapse. By binding reversibly to acetylcholinesterase, donepezil inhibits acetylcholine hydrolysis, thereby increasing acetylcholine availability at the synapses and enhancing cholinergic transmission. The U.S. Food and Drug Administration (FDA) approved the drug for the treatment of dementia in mild, moderate, and severe Alzheimer disease. Although there is currently no evidence to suggest that donepezil can alter the progression of the disease, it has shown efficacy in alleviating specific symptoms by improving cognition and/or behavior in affected individuals. In addition to its FDA-approved use in Alzheimer disease, donepezil has various off-label indications. This activity emphasizes the mechanism of action, adverse event profile, pharmacokinetics, monitoring requirements, and relevant drug interactions of donepezil. This information is crucial for interprofessional team members involved in treating patients with dementia associated with Alzheimer disease.