Drilldown: Medicines
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Donepezil: reversible AChE inhibitor, increases synaptic acetylcholine. Memantine: uncompetitive low-affinity NMDA receptor antagonist, dampens pathological glutamate overactivation while preserving normal synaptic signaling. Targets two distinct mechanisms in Alzheimer's. (1) ·
Highly β1-selective adrenergic antagonist. Greater selectivity than metoprolol or atenolol. (1) ·
Synthetic T4 (thyroxine); peripherally deiodinated to T3 (triiodothyronine), the active hormone. '"`UNIQ--vote-00000031-QINU`"' Narrow therapeutic index; brand-to-generic switches can shift TSH and require re-titration'"`UNIQ--ref-00000032-QINU`"'. (1) ·
The d-enantiomer is a highly β1-selective antagonist; the l-enantiomer triggers endothelial nitric-oxide–mediated vasodilation. Unique among beta blockers for this NO mechanism. (1) ·
'"`UNIQ--vote-00000032-QINU`"' Brand-to-brand and lot-to-lot variability in T3:T4 ratio is greater than with synthetic levothyroxine, which is why endocrine guidelines prefer the synthetic'"`UNIQ--ref-00000033-QINU`"'. (1)
'"`UNIQ--vote-00000033-QINU`"', '"`UNIQ--vote-00000034-QINU`"', '"`UNIQ--vote-00000035-QINU`"' (1) ·
'"`UNIQ--vote-00000034-QINU`"', '"`UNIQ--vote-00000035-QINU`"' (1) ·
'"`UNIQ--vote-00000468-QINU`"' (1) ·
'"`UNIQ--vote-0000059D-QINU`"' (1) ·
'"`UNIQ--vote-00000636-QINU`"', '"`UNIQ--vote-00000637-QINU`"', '"`UNIQ--vote-00000638-QINU`"' (1)
1.6 mcg/kg/d in young healthy adults; 25-50 mcg/d in elderly or cardiac disease, titrated by TSH at 6-8 weeks (1) ·
2.5–5 mg daily (HTN); 1.25 mg daily (HFrEF, slow titration) (1) ·
30 mg PO daily (1/2 grain); titrate by TSH at 6-8 weeks; 60 mg desiccated thyroid is approximately equivalent to 88-100 mcg levothyroxine (1) ·
5 mg daily (1) ·
For patients already stable on memantine 28 mg/d + donepezil 10 mg/d, switch to one capsule daily of equivalent strength (1)
15, 30, 60, 90, 120, 180, 240, 300 mg tablets (1/4 to 5 grains; 1 grain = 60 mg) (1) ·
2.5, 5, 10, 20 mg tabs (1) ·
25, 50, 75, 88, 100, 112, 125, 137, 150, 175, 200, 300 mcg tablets; oral capsule and IV/IM also available (1) ·
5, 10 mg tabs (1) ·
7/10, 14/10, 21/10, 28/10 mg ER capsules (memantine ER / donepezil) (1)
9–12 h (1) ·
T4 ~7 days; T3 ~1 day'"`UNIQ--ref-00000036-QINU`"' (1) ·
~10 h (CYP2D6 extensive metabolizers); up to 31 h (poor metabolizers) (1) ·
~60–80 h (memantine); ~70 h (donepezil) (1) ·
~7 days (euthyroid); longer in hypothyroidism (~9-10 days), shorter in hyperthyroidism'"`UNIQ--ref-00000036-QINU`"' (1)
40-80% (oral); reduced by food, calcium, iron, PPIs, fiber; take fasting with water'"`UNIQ--ref-00000037-QINU`"' (1) ·
Variable; reduced by food, calcium, iron, PPIs'"`UNIQ--ref-00000037-QINU`"' (1) ·
~100% both components (1) ·
~12% (extensive metabolizers); ~96% (poor metabolizers) (1) ·
~90% (low first-pass) (1)
Category C (2) ·
First-line in pregnancy; dose typically increased 25-30% due to estrogen-driven rise in TBG and fetal demand. Lactation safe at physiologic doses.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Not relevant (geriatric problem) (1) ·
Synthetic levothyroxine is the standard-of-care in pregnancy; desiccated thyroid use in pregnancy is not well studied<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
Showing below up to 5 results in range #1 to #5.


