Donepezil is an example of an acetylcholinesterase inhibitor. Acetylcholinesterase inhibitors are a class of medications that inhibit the activity of the enzyme acetylcholinesterase. This enzyme is responsible for breaking down the neurotransmitter acetylcholine. If acetylcholinesterase is inhibited, the concentration of acetylcholine at the synaptic cleft between nerve cells is increased subsequently, improving nerve transmissions between cells.

Mechanism of Action: Acetylcholinesterase inhibitors block the action of acetylcholinesterase. Anticholinesterase breaks down acetylcholine, decreasing the availability of the acetylcholine neurotransmitter.

Indications: Donepezil is an acetylcholinesterase inhibitor used for the treatment of cognitive symptoms associated with Alzheimer’s disease.

Nursing Considerations: When administering donepezil, nurses should be sure to administer with food in order to minimize GI upset. Donepezil should be taken once per day, typically taken at bedtime. Donepezil may increase liver function tests.

Side Effects/Adverse Effects: Common side effects of donepezil include GI upset, headaches, dizziness, insomnia, fatigue, muscle cramps, and abnormal dreams.

Patient Teaching & Education: Depending on the severity of cognitive impairment, patients may require assistance to ensure the medication is taken each day. If patients miss a dose, the dose should be taken as soon as possible unless it is close to the next dose time. If it is close to the next dose period, the individual should skip the additional dose. Patients should be instructed to take the medication with food to minimize GI upset.

Now let’s take a closer look at the medication grid on donepezil in Table 4.16.^[1]

Table 4.16 Donepezil Grid