A family asks the nurse why memantine has been added to the … | MyMerci
Medical Emergencies PA
Question

A family asks the nurse why memantine has been added to the donepezil that the client has been taking for moderate-to-severe Alzheimer disease. Which response is most accurate?

Explanation
Correct (2): Memantine is an NMDA receptor antagonist that reduces glutamate excitotoxicity. It is used in moderate-to-severe Alzheimer disease, often combined with a cholinesterase inhibitor (donepezil, rivastigmine, galantamine) for additional symptomatic cognitive benefit — the two mechanisms are complementary, not redundant. (1) Not a replacement. (3) Different mechanism. (4) Alzheimer is not reversed; both classes slow decline modestly.

In-depth explanation

Memory Tip Memantine = NMDA blocker (named "Memantine for Memory in moderate-severe"). ChEi (donepezil/rivastigmine/galantamine) used in mild-moderate; add memantine in moderate-severe.

Clinical scenario

Scenario 82-year-old female, moderate-to-severe Alzheimer disease on donepezil for 2 years. Provider adds memantine 10 mg PO BID. Family asks about combination rationale.

Key concepts

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For study reference only. Always follow current clinical guidelines and your institution’s protocols.