Tacrine 

Overview 

A cognitive-enhancing drug called Tacrine is used to treat mild-to-moderate Alzheimer’s disease dementia. cognitive and memory decline in Alzheimer’s disease and other types of dementia, could be connected to cholinergic neuron degeneration. The enzyme cholinesterase is inhibited by Tacrine that degrades the neurotransmitter acetylcholine. Acetylcholine levels in the brain are raised as a result, improving and maintaining the health of cholinergic neurons and enhancing memory and cognitive performance in general. 

Information about Dosing 

Tacrine is typically started at a dose of 10 mg four times a day, or 40 mg a day. This should be given to the patient dose before it is raised for at least four weeks. It is necessary to get laboratory testing to monitor liver function beginning in the fourth week of treatment and continuing every other week for the following four months. The dose may be raised to 20 mg a day (equivalent to 80 mg) four times if liver function test results are normal.

 The dose may be raised to 30 mg four times a day (120 mg/day) in an additional four to six weeks. then once more in 4-6 weeks, up to 160 mg/day if tolerated. The ideal daily dose range is 120–160 mg, although the daily dose shouldn’t be more than 160 mg. 

Typical Side Effects 

The most typical Tacrine adverse effects are nausea, vomiting, diarrhea, indigestion, and sleeplessness. trembling, cramping in the muscles, hunger loss, and weight loss. When doses are larger, these effects occur more often, but the most of the time the side effects are very temporary and minor, going away in 1-3 weeks with continuing treatment. Tacrine may make you drowsy and dizzy, particularly when you first start treatment. 

Adverse Events and Safety Measures 

Liver poisoning is linked to Tacrine. Tacrine shouldn’t be administered to anyone who have a history of liver illness but could benefit from using one of the other brain boosters. Tacrine therapy requires careful observation of hepatic function. Transaminase levels, which are measured by blood tests, are vital for identifying first indications of liver damage. A sign of liver damage is elevated liver transaminase enzyme levels. 

Four weeks after starting tacrine, blood tests are conducted to assess liver enzymes. The tests continued every other week for the next four months. After then, levels of transaminase are measured every three months during the duration that the patient is receiving Tacrine. abnormal liver function or elevated liver enzymes, the findings of the test may need lowering the daily dose of Tacrine or stopping the medication. 

Patients should disclose to their surgeon that they are taking Tacrine before any operation, as it may interfere with any anesthetic that relaxes the muscles that they may be given. 

Heart rate may be slowed down with tacrine. Individuals who are taking medicine for cardiac conduction issues, have a history of dizziness associated with, or have a history of slow heart rate (bradycardia) When using Tacrine, heart issues need to be properly watched. 

Seizures may occur with Tacrine in those who are vulnerable, albeit this side effect is quite uncommon. Still, Alzheimer’s disease may sometimes show symptoms in the form of seizures.

Individuals who have had asthma attacks or chronic obstructive pulmonary disease should be constantly watched while using Tacrine. Tacrine may make lung conditions worse. 

Gastric acid discharges may rise when using Tacrine. Individuals who have had ulcers in the past or who are taking NSAIDs (steroidal anti-inflammatory medicines), such naproxen or ibuprofen, should be constantly watched for indicators of bleeding in the gastrointestinal tract. 

Potential Interactions with Drugs 

Tacrine and severe medication interactions are rare. The medication interactions that are clinically significant Tacrine reports are compiled in the following below. 

• Alcohol consumption should be avoided by Tacrine patients since the combination may exacerbate sedation and fatigue. Additionally, alcohol’s sedative properties may have a depressive impact, masking its therapeutic benefits of Tacrine and making therapy more difficult. 
• Agents that are anticholinergic (e.g., Cogentin) When combined, anticholinergic medications and Tacrine together, may be in opposition to one another’s actions, diminishing their potency. 
• NSAIDs, or nonsteroidal anti-inflammatory medications, (For example, naproxen, ibuprofen, and aspirin) Given that NSAIDs are linked to an increased risk of stomach ulcers and Tacrine might increase the release of stomach acid, this combination may make stomach problems more likely bleeding. 
• Cimetidine, or Tagamet, Tagamet could prevent Tacrine from metabolizing and raise its pharmacological and blood levels activities that might have a negative impact.

overindulgence 

High levels of acetylcholine resulting from a Tacrine overdose may cause a cholinergic crisis. Severe nausea, vomiting, salivation, a slowed heartbeat, perspiration, low blood sugar, and low blood pressure, seizures, respiratory depression, and weakening of the muscles. A Tacrine overdose may be fatal. 

Treating any suspected overdose as an emergency is imperative. The individual has to be brought to the emergency space for care and observation. It is advisable to bring the prescription bottle of medicine (as well as any additional medication that may have been taken in excess) since the information on the label may be useful in helping the treating physician figure out how many tablets the patient has taken. 

Particular Points to Remember 

• Take the missed dosage as soon as you remember. Ignore the missed dosage if the next scheduled dose is approaching and go on with your usual dosage regimen. Avoid taking two doses at once. 
• Tacrine must be taken regularly throughout waking hours, separated by three to four hours, in order to be effective. Take the drug, for instance, before bed and throughout meals. 
• Eat before taking Tacrine to prevent stomach distress. 
• Prolonged diarrhea and vomiting may lead to electrolyte loss and dehydration, which can be hazardous, particularly for elderly people. Notify your doctor if you have chronic diarrhea or vomiting for longer than a day. 
• Tacrine may make you drowsy and dizzy, particularly when starting treatment, and it may affect your attentiveness. When driving or doing other duties that call for attentiveness, proceed with care. 
• Keep the medicine out of direct sunlight and dampness, in the light-resistant container that came with it. Warmth and Moisture may hasten the disintegration of your prescription and cause it to lose its medicinal benefits. 
• Make sure kids can’t get to your medicine.