Donepezil

AKA: Aricept.

Effects: Increases the availability of acetylcholine in the brain, improving memory in Alzheimer's patients for a short period of time.

FK506

AKA: Prograf, Tacrolimus.

An immune-suppressing drug used to prevent transplanted organs from being rejected.

Effects: It has been found to cause neurons to grow new fibers that connect to other brain cells, which could possibly overcome brain damage caused by strokes, Alzheimer's disease, and Parkinson's disease.

Precautions: It should not be taken by transplant patients who are sensitive or allergic to FK506. The elderly may be given a lower dosage to compensate for loss of kidney function.

It may cause kidney damage in liver patients, especially in high doses, and mildly elevate blood potassium. It may also cause tremors, headaches, changes in muscle function, seizures, changes in mental state and sense perception, or other nervous-system problems. It may increase the chance of developing a lym-phoma or other malignancy; a viral infection related to Epstein-Barr may also occur. A mild to moderate elevation in blood pressure may indicate kidney damage.

Common side effects include headaches, tremors, sleeplessness, tingling in the hands and feet, diarrhea, nausea, constipation, loss of appetite, vomiting, dental infections (in the absence of good oral hygiene, or where careless or excessive brushing and flossing causes bleeding), liver or kidney abnormalities, high blood pressure, urinary infection, decreased frequency of urination, anemia, increased white blood cells count, reduced blood-platelet count, changes in blood potassium level, reduced blood magnesium, high blood sugar, lung problems (including fluid in the lungs), breathing difficulties, itching, rash, abdominal pains, pain, fever, weakness, back pains, buildup of abdominal fluid, and fluid retention.

Less common side effects include dream abnormalities, anxiety, confusion, depression, dizziness, instability, hallucinations, poor coordination, muscle spasms, psychosis, tiredness, strange thoughts, visual disturbances (including double vision), a ringing or buzzing in the ears, upset stomach, a yellow discoloration in the skin or whites of the eyes, swallowing troubles, stomach gas, stomach bleeding, fungus infection of the mouth, bloody urine, chest pain, rapid heartbeat, low blood pressure, diabetes, black-and-blue marks on the skin, aching in the muscles and joints, leg cramps, muscle weakness, asthma, bronchitis, coughing, sore throat, pneumonia, a stuffy and runny nose, sinus irritation, voice changes, sweating, skin rashes, and herpes infections.

An overdose will result in increased side effects.

Excessive suppression of the immune system can occur when it is taken with other immunosuppressants. Additional kidney damage may occur when taken with other drugs that cause kidney problems, such as aminoglyco-side antibiotics, Amphotericin B, Cis-platin, and —when taken within 24 hours of each other — Cyclosporine. Blood levels of FK506 (and attendant side effects) can increase when taken with antifungal drugs, Bromocriptine, calcium channel blockers, Cimetidine, Clarithromycin, Danazol, Diltiazem, Erythromycin, Methylprednisolone, and Metoclopramine; blood levels of FK506 can be decreased by Carbamazepine, Phenobarbitol, Phenytoin, Rifampin, Rifampicin. Vaccination efficacy may be reduced by FK506, and live vaccines such as BCG, measles, mumps, oral polio, rubella, TY 21 typhoid, and yellow fever should be avoided. The drug should be taken one hour before or two hours after meals to avoid absorption be food.

Dosage: For its use in transplant surgery, the usual dose is 0.075 to 0.15mg per pound of body weight a day in 2 divided doses, often adjusted to the lowest effective level to reduce side effects.

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