ABSTRACT
Alzheimer's disease (AD) occurs more frequently in women, with an incidence greater than expected from longevity alone--a finding possibly related to reduced estrogen levels. The epidemiology, societal costs, clinical presentation, pathophysiology, etiology, and treatment of AD are reviewed. At present, only two drugs, tacrine and donepezil, are approved for treatment of AD. These drugs enhance central cholinergic activity by inhibiting cholinesterase. The goal of current drug development research is to halt progress of AD, and efforts are underway to discover ways to restore neuronal activity via neurotrophins and to prevent neuronal loss. Pharmacists are well positioned to assist AD patients (in the early stages) and caregivers by encouraging early intervention and by presenting realistic expectations about the disease and its treatment. A number of easily accessible resources for health care providers and consumers are presented.
Subject(s)
Alzheimer Disease/drug therapy , Pharmacists , Cholinesterase Inhibitors/therapeutic use , Donepezil , Female , Humans , Indans/therapeutic use , Male , Nootropic Agents/therapeutic use , Piperidines/therapeutic use , Tacrine/therapeutic useABSTRACT
Estrogen-progestin combination oral contraceptives (COCs) are well tolerated, offer high reliability, convenience, and ready availability, but require strict adherence to dosing guidelines. Progesterones work by inhibiting ovulation, thickening cervical mucus, and/or suppressing endometrial growth. An FDA advisory committee has concluded that the benefits outweigh the risks of the mifepristone/misoprostol regimen for use in the United States. IUDs are a good choice for women who want to avoid the inconvenience of barrier methods and who cannot use other forms of contraception. Barrier contraceptives offer low cost and easy availability, but lower effectiveness than other methods.
