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Old 10-03-2009, 01:19 AM   #1
Sasha
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Default Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

While this is not specifically EMS news, I do think it's important for those in EMS to keep up to date on medications they may encounter.

Aricept, or donepezil, is a big dementia drug and I see it listed often in my patient's med list, so this perked my interest and I figured I would share.

Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate
Full Article: http://www.elements4health.com/alzhe...eart-rate.html
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According to the analysis of data from a study of 1.4 million people aged 67 and older, people taking one of several drugs commonly prescribed to treat Alzheimer's disease are more likely to be hospitalized for a potentially serious condition called bradycardia than patients not taking these medications.
The study found that the risk of abnormally slow heart rate is twice as high in those taking drugs to slow Alzheimer's disease.

Cholinesterase inhibitors are commonly prescribed to delay the progression of symptoms such as confusion and long-term memory loss in people with mild to moderate Alzheimer's disease.

The benefits of cholinesterase inhibitors for people with Alzheimer's disease are generally small. Thy do not reverse the effects of dementia and other research suggests that in about half of patients, they delay the worsening of symptoms for between six months to a year, although a minority of patients may benefit more.

Bradycardia is defined as an abnormally slow resting heart rate (under 60 beats per minute). Although it can be asymptomatic, it can also cause fainting, palpitations, shortness of breath, or even death.

The three cholinesterase inhibitors currently approved for use in Canada are donepezil, rivastigmine, and galantamine. Most of the Alzheimer's disease patients whose records were analyzed for the study had been prescribed donepezil.

The results of the study showed that older patients hospitalized with bradycardia were more than twice as likely to have recently started on a cholinesterase inhibitor such as donepezil for Alzheimer's disease compared to those without bradycardia.
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Old 10-03-2009, 10:25 AM   #2
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Default Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

Why wouldn't it be EMS news? We are responsible for finding out what medications a patient is taking and reporting it to the E.R.

While EMT's and Paramedics aren't expected to know EVERY side effect of every drug, this may be something to keep in mind when we are caring for Alzheimer's patients and if there IS marked Bradycardia and the patients is taking Aricept or an associated medication, that's rather an important finding to report wouldn't you think?
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Old 10-03-2009, 01:22 PM   #3
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Default Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

I couldn't agree more with Corn, this is something nice to keep tucked in the back of your brain when you're scratching your head on a patient that is bradycardic and nothing else is making any sense.

Hopefully, they don't pull these Alzheimer's drugs though. I think, as long as the bradycardia is treatable the patient should at least have a chance at a more normal life for as long as possible.

Thanks for posting this!
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Old 10-03-2009, 02:26 PM   #4
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Default Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

Quote:
Originally Posted by CornholioMedic View Post
Why wouldn't it be EMS news? We are responsible for finding out what medications a patient is taking and reporting it to the E.R.

While EMT's and Paramedics aren't expected to know EVERY side effect of every drug, this may be something to keep in mind when we are caring for Alzheimer's patients and if there IS marked Bradycardia and the patients is taking Aricept or an associated medication, that's rather an important finding to report wouldn't you think?
You are correct. Sorry, you have to forgive me. I came from a forum where if it didn't involve pretty lights, sirens or cool skills it wasn't considered ems news. I agree its something to keep in mind, and a good thing for EMSers to know, which is why I posted it. :)
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Old 10-03-2009, 02:30 PM   #5
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Default Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

Quote:
Originally Posted by Sasha View Post
You are correct. Sorry, you have to forgive me. I came from a forum where if it didn't involve pretty lights, sirens or cool skills it wasn't considered ems news. I agree its something to keep in mind, and a good thing for EMSers to know, which is why I posted it. :)
Oh, you were a medic on the show Trauma?

sorry, couldn't resist....

Feel free to post it here, I think you'll find us to be a little more realistic about being "real" EMS as opposed to the other sites floating around out there.
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Old 10-03-2009, 02:34 PM   #6
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Cool Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

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Old 10-25-2009, 10:07 PM   #7
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Default Re: Alzheimer's Disease Drugs Increase Risk of Abnormally Slow Heart Rate

Lol, that reply was priceless, prncssmdc. Great info there Sasha, found any further info as to the AMA issuing the same warning yet?

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