Flashcards in 00 Parkinson's Disease Deck (33):
What are believed to be the causes of Parkinson's Disease?
Degeneration of DOPAMINERGIC neurons (specifically in the substantia nigra). Decrease of dopamine leads to predominance of (pseudo-overactivity) of Acetylcholine
What are the different classes of medication that can be used for Parkinson's Disease?
Dopamine agonists, Anticholinergic agents, COMT-Inhibitors, MAO-I's
All patients with PD should avoid what type of medications?
Dopamine antagonists (i.e. conventional antipsychotics, some atypical antipsychotics (risperidone, ziprasidone, olanzapine), metoclopramide, and phenothiazines (including promethazine and prochlorperazine)
If a patient with PD needs an antipsychotic agent, what are the best agents to choose?
Quetiapine or Clozapine (neither had D2 antagonism)
What is the generic name of Symmetrel?
Amantadine (DA agonist)
What is the generic name of Parlodel?
Bromocriptine (DA agonist)
What is the generic name of Mirapex?
Pramipexole (DA agonist)
What is the generic name of Requip?
Ropinirole (DA agonist)
What is the generic name of Neupro?
Rotigotine (DA agonist)
What is the generic name of Apokyn?
Apomorphine (DA agonist)
When does Amantadine need to be dose adjusted?
Significant renal adjustment required. Once CrCl < 15, dosed once a week
What are the most common ADRs with Amantadine?
What are the most common ADRs with Bromocriptine?
Which DA agonists are also approved for Restless Leg Syndrome (RLS)?
Pramipexole, Ropinirole, Rotigotine
How is Apomorphine administered?
SQ only! Dosed in mL, not mg!!!
What is the most common ADR with Apomorphine?
N/V (must be given with antiemetic (trimethobenzamide 300mg po TID)
When is Apomorphine contraindicated?
DO NOT GIVE w/ 5-HT3 antagonists (d/t hypotension and loss of consciousness)
What is the generic name of Eldepryl, Zelapar?
What is the generic name of Azilect?
When should Azilect (Rasagiline) be avoided?
With moderate to severe hepatic impairment. AVOID HIGH TYRAMINE FOOD
What is the generic name of Tasmar?
Why is Tasmar (Tolcapone) not used much anymore?
BBW: Acute fulminant liver failure
What is the generic name of Comtan, Stalevo?
What is the generic name of Sinemet, Parcopa?
Levodopa w/ Carbidopa
When is Sinemet contraindicated?
Hx of melanoma, Current nonselective MAO-Is, Narrow angle glaucoma
What must COMT medications be given with?
Have to be given with Levodopa, useless when used by themselves since they are used to increase Levodopa's AUC
Which Dopamine Agonists are Ergot Derivatives?
What ADRs do the ergot derivative Dopamine Agonists cause?
Non-ergot DA agonists are more likely to cause what side effects?
Which medications have been associated with compulsive gambling?
What is the max dose/day of Selegiline? Why?
10mg, lose selectivity
What needs to be monitored in patients receiving Tolcapone?