Donepezil

Donepezil

Drug monograph · NCLEX study reference
Trade names	Aricept
Therapeutic class	Anti-Alzheimer
Pharmacologic class	Cholinesterase inhibitor
Onset / peak / duration	Effect over weeks; once daily.
Half-life / level	Half-life about 70 hours; level not routine.
Routes	PO (oral)
High-alert (ISMP)	No
Black box warning	None
Antidote / reversal	Atropine for severe cholinergic effects.
Pregnancy / lactation	Not typically used.

Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and must be verified against current manufacturer labeling before clinical use. This is educational content, not prescribing guidance.

Donepezil (brand name Aricept) — Anti-Alzheimer; Cholinesterase inhibitor.

Identification

• Therapeutic class: Anti-Alzheimer.
• Pharmacologic class: Cholinesterase inhibitor.

Pharmacology

• Mechanism of action: Inhibits acetylcholinesterase to raise acetylcholine and support cognition.
• Onset / peak / duration: Effect over weeks; once daily.
• Half-life / therapeutic level: Half-life about 70 hours; level not routine.

Clinical use

• Indications: Alzheimer dementia (all stages).
• Usual dose, route, frequency: 5 to 10 mg PO at bedtime; ODT available.
• Maximum dose / adjustments: Titrate to tolerance.

Safety

• Contraindications: Hypersensitivity.
• Black box warning: None.
• Interactions: Anticholinergics oppose effect, beta blockers (bradycardia), NSAIDs (GI bleeding).
• Pregnancy / lactation: Not typically used.
• High-alert: No.

Adverse effects

• Common side effects: Nausea, diarrhea, insomnia, vivid dreams.
• Serious effects to report: Bradycardia, syncope, GI bleeding.
• Antidote / reversal: Atropine for severe cholinergic effects.

Nursing process

• Assessment before administration: Heart rate, cognitive baseline, GI and ulcer history.
• Interventions during therapy: Monitor heart rate and GI symptoms.
• Monitor: Cognition, heart rate, GI tolerance.
• Evaluation / expected outcome: Slowed cognitive decline.

Patient teaching

• Patient teaching: Take at bedtime; effects are gradual.
• Notify provider if: Fainting, slow heartbeat, black stools.
• Administration tips: Bedtime; with or without food.