Hey all, welcome back to the Real Life Pharmacology podcast.

I'm your host, Eric Christensen, FarmD, BCPS, BCGP.

And today what I'm going to cover is rivestigmin.

Rivestigmin is an acetylcholine esterase inhibitor.

So I have covered Dinepazil.

That's another acetylcholine esterase inhibitor in the same class. But I did want to cover rivistigmin specifically because there are a couple of quirks that definitely are

different. And I can share my clinical practice experience with this medication as well. So being in this class as a refresher,

acetylcholine esterase inhibitors prevent the breakdown of acetylcholine. And it's theorized that a deficiency

in acetylcholine in the brain leads to certain forms of dementia,

Alzheimer's as well as potentially a component of Parkinson's type dementia as well.

So with that, with this drug, we're trying to prevent the breakdown of that acetylcholine

and increase concentrations in the brain

and potentially help manage the symptoms of certain types of dementia.

Very, very important to remember that this drug does not reverse dementia.

So sometimes that's an expectation of patients, caregivers,

you know, friends, family, that dementia medications can potentially help reverse this, or they'll be,

you know, totally 100% back to normal. And we know from the studies and evidence that that's absolutely not going to be

the case. So definitely coach and educate patients that this isn't going to reverse their dimension.

They're not going to be totally back to the way they used to be. However, if we can give them a little

bit more capacity for memory and some of the symptoms that go along with dementia, that can

certainly be helpful and be comforting to some there. So that's the mechanism in short there.

Doseage forms, this is kind of one of the big differences with denepazil

...