Donepezil Rivastigmine and Galantamine

  1. Bethanechol
  2. Carbachol
  3. Methacholine
  4. Pilocarpine
  5. Donepezil Rivastigmine and Galantamine
  6. Edrophonium
  7. Neostigmine
  8. Physostigmine
  9. Pyridostigmine


Donepezil, rivastigmine and galantamine are cholinesterase inhibitors that increase cerebral levels of acetylcholine. They are approved for symptomatic treatment of Alzheimer disease, and can cause side effects associated with cholinergic overstimulation.

Key Points

  • Donepezil, Rivastigmine, Galantamine
    • Mechanism
      • Acetylcholinesterase inhibitor
        • Increases ACh levels in the brain by preventing its breakdown
        • Thought to increase M1 signaling in brain
    • Clinical Use
      • Alzheimer Disease
        • Decreased acetylcholine levels are a common feature in Alzheimer's disease
        • Drugs improve cognition, behavior, and functioning in activities of daily living
        • Not curative; cannot reverse neurodegeneration
    • Adverse Effects
      • Nausea, dizziness, insomnia