2. In the face of rapid decline, tapering and discontinuation may be tried. Patient must be carefully monitored for
rapid decline upon discontinuation. 如衰退迅速，减量和停药可以尝试。但病人应被严密监护。
3. The decline that occurs after drug discontinuation is thought to be the point the patient would have been if cholinesterase inhibitor treatment had not been initiated.如在停药后病情进展，应认为胆碱酯酶抑制治疗没有进行病人应到这个状态
There was a high correlation between both doneperil serum concentrations and percent of acetylcholinesterase inhibition and changes in ADAS-Cog scores. 在多奈呱齐血浓度和胆碱酯酶抑制作用及ADAS-Cog得分改变之间有密切关系
Plateau acetylcholinesterase inhibition of 76%-84% occurred with donepezil plasma concentrations greater than 50
ng/ml. 当血药浓度超过50ng/ml时胆碱酯酶抑制率在76%-84%
5 mg daily yielded mean steady-state inhibition of ~64%. 5mg每天表现出稳定抑制率为64%
tapering ['teip?ri?]
adj. 尖端细的；渐渐减少的
v. 逐渐变尖细；逐渐减少（taper的ing
形式） discontinuation ['d?sk?n,t?nj?'e???n] n. 中止（等于discontinuance）；停止；废止
serum ['s??r?m]
n. 血清；浆液；免疫血清；乳清；树液
acetylcholinesterase [?'si:til,k?uli'nest?reis] n. 乙酰胆碱酯酶 Plateau ['pl?t?u; pl?'t-] 高原 | 高地 | 平稳时期
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Antioxidants 抗氧化剂
Vitamine E 1000IU bid. 维E1000IU日两次
Favorable side effect profile. 无副作用
Low cost. 低费用
It is considered the preferred treatment,
and it can be continued indefinitely. 被并可以无限持续
Vitamine E + doneperil – not evaluated
yet. 维E+多奈哌齐-未评价
Vitamine E + doneperil – no complications reported.维E+多奈哌齐-未并发症报道
indefinitely [?n'def?n?tl?]
adv. 不确定地，无限期地；模糊地，不明确地
Estrogen雌激素
1. Only post hoc analysis, lacking randomized clinical trials. 仅临床前分析，缺乏随机临床试验
2. Benefit/risk profile – if the woman is not at risk for either endometrial cancer or breast cancer, a trial of estrogen
is
reasonable. 益处/风险对比-如果该妇女没有子宫内膜癌或乳腺癌的危险，雌激素试验
是可行的 3. Doses are the same as for ERT.剂量同ERT
4. Maybe used in combination with
either donepezil or vitamine E. 可与多奈
哌齐或维E合用 estrogen ['estr?d??n] n. 雌性激素
post hoc ['p?usth?k'?:ɡ?u'pr?pt?h?k] （拉）因此；事后比较；因果颠倒 randomized ['r?nd?,maizd] adj. [数] 随机化的，随机的
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v. 使随机化；做任意排列（randomize的过去分词）
endometrial [,end?u'mi:tri?l] adj. [解剖] 子宫内膜的
Anti-inflammatory agents 抗炎因子
Although data from epidemiologic studies are interesting and promising, NSAIDs have a significant incidence of adverse effects, particularly gastritis and the possibility of GI bleeds. 尽管流行病学研究数据是有意义的和有希望的，非甾体抗炎药有一个明显的副作用，特异性胃炎和消化道出血
No multicenter, controlled trials.无多中心的，对照试验
NSAIDs are not recommended for
general use in the treatment of AD at the present time. 现在非甾体抗炎药并没有被认为是治疗AD的基础药物.
inflammatory [?n'fl?m?t(?)r?] adj. 炎症性的；煽动性的；激动的 epidemiologic ['epi,di:mi?'l?d?ik,-k?l] adj. 流行病学的；传染病学的 promising ['pr?m?s??]
v. 许诺，答应（promise的现在分词形式）
adj. 有希望的，有前途的 incidence ['?ns?d(?)ns]
n. 发生率；影响；[光] 入射；影响范围
gastritis [g?'stra?t?s] n. [内科] 胃炎
Gastrointestinal bleeding(GI) 消化道出血
gastrointestinal [,g?str???n'test?n(?)l] NSAIDs
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n. 非甾体抗炎药（Non-Steroidal similar symptoms in nondemented patients, Antiinflammatory Drugs）；非类固醇抗炎药
steroidal [st?'r?id?l]: adj. 甾族的
Pharmacotherapy of noncognitive symtoms非认知障碍症状的药物治疗 The majority of patients with AD will manifest noncognitive symptoms at some point in the illness. 大部分AD患者将出现非认知症状在病程的某个时期
The symptoms can be divided into three categories:分三类
psychotic symptoms 精神病症状 disruptive behavior 人格分裂 depression 抑郁 Problems 问题
Despite the widespread nature of noncognitive symptoms in AD, there is little formal research on psychotropic drug efficacy in these patients. 尽管ＡＤ的非认知障碍症状很广泛，但对这些病人很少有正规研究以获得有效药物．
Although information can be extrapolated from studies using psychotropic drugs for
the widespread neuronal loss seen in AD and different underlying pathology suggest that this approach may not be valid. 尽管从应用精神药物治疗非认知障碍病人类似症状可以推断出信息，但从AD患者广泛神经元缺失和内特殊病理改变考虑此种推断可能没有价值。
pharmacotherapy [,fɑ:m?k?u'θer?pi] n. 药物疗法 manifest ['m?n?fest]
adj. 显然的，明显的；明白的 n. 载货单，货单；旅客名单 vt. 证明，表明；显示 vi. 显示，出现 categories ['k?t?g(?)r?z]
n. 类别（category的复数）；分类 psychotic [sa?'k?t?k] n. 精神病患者；疯子 adj. 精神病的 disruptive [d?s'r?pt?v]
adj. 破坏的；分裂性的；制造混乱的
psychotropic [,sa?k?(?)'tr??p?k] adj. 治疗精神病的
extrapolate [?k'str?p?le?t] vt. 外推；推断 vi. 外推；进行推断
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pathology [p?'θ?l?d??] n. 病理学（复数pathologies）
General guidelines 一般指导方针
1. Use reduced doses 用少剂量 2. Monitor closely 密切监护 3. Document carefully. 仔细记录 4. Many psychotropic medications have anticholinergic effects that may actually
worsen
cognition. 很多促神经药物都有抗胆碱能药的作用可以加重症状
psychotropic [,sa?k?(?)'tr??p?k] adj. 治疗精神病的 medication [med?'ke??(?)n] n. 药物；药物治疗；药物处理 anticholinergic [,?nt?,k??l?'n?:d??k] adj. 反副交感神经生理作用的 制止副交感神经系统冲动的药剂
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