Which cholinergic agent is typically prescribed for Alzheimer's patients who are sensitive to gastrointestinal side effects?

Rivastigmine is the correct cholinergic agent prescribed for Alzheimer's patients who may be sensitive to gastrointestinal side effects due to its unique formulation and administration. Rivastigmine has a transdermal patch available, which can help mitigate common gastrointestinal issues associated with oral cholinergic medications such as nausea and vomiting. This delivery method allows for a steady absorption of the medication, reducing fluctuations in plasma concentration and minimizing the likelihood of gastrointestinal distress, which is particularly beneficial for patients who may have a more sensitive digestive system.

Other agents for treating Alzheimer's, such as donepezil and galantamine, are administered orally and are more commonly associated with gastrointestinal side effects. While memantine is also used to treat Alzheimer's disease, it operates through a different mechanism, primarily acting on the glutamatergic system rather than the cholinergic system, and does not have the specific profile related to cholinergic side effects. Thus, for patients needing careful management of gastrointestinal tolerability, rivastigmine stands out as the more suitable option.