donepezil hydrochloride (Aricept jelly / donepezil jelly)

Synergistic approaches to Alzheimer's disease: exploring the combined efficacy of phytoconstituents and conventional drugs.

Kumar Abhishek A

Cognitive functions deteriorate with Alzheimer's disease (AD), a kind of degenerative disease. Problems with memory, interpersonal interactions, problem-solving, and other cognitive functions that limit a person's ability to do daily tasks are the hallmarks of dementia. This condition affects about 50 million individuals globally. Traditional therapies for AD, like galantamine, donepezil, and memantine, only offer symptomatic alleviation through glutamatergic regulation and cholinergic augmentation, making AD a significant worldwide health concern. This review assesses the possibility of improving the effectiveness of therapy by combining significant phytoconstituents with traditional AD therapies. A complete literature review was carried out using peer-reviewed publications, experimental investigations, and review papers published from 2010 to 2025. The primary objective of the investigation was to study the interaction between phytoconstituents and conventional therapy in the treatment of Alzheimer's disease. Our outcomes demonstrate the powerful multi-target adjuvant properties of curcumin, resveratrol, quercetin, berberine, and luteolin. In particular, Berberine and Quercetin considerably reduce neuroinflammation and oxidative stress through the Nrf2/HO-1 and NF-κB pathways, whereas Curcumin and resveratrol enhance the anti-amyloidogenic effects of conventional medications. Additionally, luteolin exhibits a special capacity to regulate tau hyperphosphorylation, which enhances memantine's stabilising neurotransmitter actions. The primary objective of therapy has shifted from symptomatic relief to disease modification by the synergy between phytoconstituent and conventional drugs. These combinations preserve the structural integrity of the cholinergic synapse by concurrently mitigating oxidative stress and amyloid toxicity. A possible paradigm shift towards holistic neuroprotection is represented by the incorporation of these five essential phytoconstituents into traditional AD regimens. To ensure clinical translatability, future research must now focus on nanoformulations that can overcome the limited bioavailability of substances like curcumin. These methods may improve treatment effectiveness, lessen adverse effects, and reduce the chance of resistance, providing a more thorough method of handling the complexities of AD.

A mysterious jelly seems to be left behind by toads.

Bilateral Lower Extremity Edema During Donepezil Treatment: A Case Report.

Kang Kyusik K

Introduction/ Background: Acute bilateral lower-extremity edema is uncommon and often results from medication side effects, acute heart failure, nephrotic syndrome, or bilateral deep vein thrombosis. Drugs such as dihydropyridine calcium channel blockers, corticosteroids, thiazolidinediones, and nonsteroidal anti-inflammatory agents are known to cause edema. Donepezil, a widely used acetylcholinesterase inhibitor for Alzheimer's disease, has not been previously linked to leg edema. Recognizing rare adverse reactions is essential for patient safety, as edema may indicate serious conditions. Case Presentation: A 75-year-old woman with Alzheimer's disease developed bilateral pitting lower leg edema six months after starting treatment with donepezil. She had no history of cardiac, renal, hepatic, or venous diseases. Laboratory tests, electrocardiography, chest X-ray, and computed tomography venogram were normal, except for mild anemia and a slightly reduced estimated glomerular filtration rate. The edema resolved three weeks after discontinuation and did not recur after the administration of rivastigmine. Conclusion: The temporal association and resolution upon drug cessation suggest a probable association. Possible mechanisms may include cholinergic-induced vasodilation, which increases capillary permeability.

Correction to: In vitro comparative quality evaluation of different brands of metformin hydrochloride tablets available in Mekelle City, Tigray Regional State, Ethiopia.

Welegebrial Brhane Gebrehiwot BG, Gezae Zenawi Z, Gebrekidan Samrawit Kidanemariam SK, Gebrerufael Gebru Gebremeskel GG et al.