An older adult patient has confusion, memory loss, and disorientation in familiar surroundings. The patient has been taking donepezil (Aricept) 10 mg once daily for 6 months
The patient's symptoms have begun to worsen, and the patient's spouse asks if the medication dose can be increased. What will the nurse tell the spouse?
a. The dose can be increased, because the patient has been taking the drug for longer than 3 months.
b. The dose can be increased to twice daily dosing instead of once daily dosing.
c. The increase in symptoms is the result of hepatotoxicity from the medication's side effects.
d. The patient must take the drug for longer than 1 year before the dose can be increased.
ANS: A
Donepezil is given for mild, moderate, and severe AD, and dosing may be increased, although it must be titrated up slowly. For patients with moderate to severe AD who have taken 10 mg once daily for at least 3 months, the dose can be increased to 23 mg once daily. Donepezil is not given twice daily. Donepezil does not cause hepatotoxicity; hepatotoxicity occurs with tacrine, the first acetylcholinesterase (AChE) inhibitor, which now is rarely used. Dosing is increased after 3 months, not 1 year.
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