Tacrine
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| Image:Tacrine2.png | |
| Image:Tacrine3d.png | |
| Tacrine
| |
| Systematic (IUPAC) name | |
| 1,2,3,4-tetrahydroacridin-9-amine | |
| Identifiers | |
| CAS number | |
| ATC code | N06 N06DA01 |
| PubChem | |
| DrugBank | |
| Chemical data | |
| Formula | C13H14N2 |
| Mol. mass | 198.264 g/mol |
| Pharmacokinetic data | |
| Bioavailability | 2.4–36% (oral) |
| Protein binding | 55% |
| Metabolism | Hepatic (CYP1A2) |
| Half life | 2–4 hours |
| Excretion | Renal |
| Therapeutic considerations | |
| Pregnancy cat. | |
| Legal status |
S4 (Au), POM (UK), ℞-only (U.S.) |
| Routes | Oral, rectal |
Tacrine is a parasympathomimetic and a centrally acting cholinesterase inhibitor (anticholinesterase). It was the first centrally-acting cholinesterase inhibitor approved for the treatment of Alzheimer's disease, and was marketed under the trade name Cognex. Tacrine was first synthesised by Adrien Albert at the University of Sydney.
Clinical use
Tacrine was the prototypical cholinesterase inhibitor for the treatment of Alzheimer's disease. Studies have found that it may have a small beneficial effect on cognition and other clinical measures, though adequate study data is limited and the clinical relevance of these findings is unclear.[1][2]
The use of tacrine is limited by poor oral bioavailability, the necessity for four-times daily dosing, and considerable adverse drug reactions (including nausea, diarrhea, urinary incontinence and hepatotoxicity) such that few patients could tolerate therapeutic doses.[3]
Other newer cholinesterase inhibitors, such as donepezil, are now preferred over tacrine.
Overdosage/Toxicity
As stated above, overdosage of tacrine may giva rise to severe side effects such as nausea, vomiting, salivation, sweating, bradycardia, hypotension, collapse, and colvulsions. Tertiary anticholinergics, such as atropine, may be used as an antidote for overdose.
Major form of metabolism is in the liver via hydroxylation of benzylic carbon by CYP450. This forms the major metabolite 1-hydroxy-tacrine (velnacrine) which is still active.
References
- ↑ Qizilbash N, Whitehead A, Higgins J, et al. Cholinesterase inhibition for Alzheimer disease: a meta-analysis of the tacrine trials. JAMA 1998;280(20):1777-82. PMID 9842955
- ↑ Rang HP, Dale MM, Ritter JM, Moore PK. Pharmacology, 5th edition. Edinburgh: Churchill Livingstone; 2003.
- ↑ Sweetman S, editor. Martindale: the complete drug reference, 34th ed. London: Pharmaceutical Press; 2004. ISBN 0-85369-550-4
See also
Anticholinesterases (N06DA, N07AA) | |
|---|---|
| Carbamates | Ambenonium - Demecarium - Stigmine (Neostigmine, Physostigmine, Pyridostigmine, Rivastigmine) |
| Other | Galantamine - Metrifonate - Donepezil - Tacrine - Edrophonium |
Psychoanaleptics: anti-dementia drugs (N06D) | |
|---|---|
| Anticholinesterases | Tacrine - Donepezil - Rivastigmine - Galantamine |
| Other | NMDA receptor antagonist (Memantine) - Ginkgo biloba |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
