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Pharmacology 2 > Antiparkinson Agents > Flashcards

Antiparkinson Agents Flashcards

5 questions

1
Q

what are the 4 big symptoms of Parkinson’s disease?

A

bradykinesia
rigidity
resting tremor
impaired balance

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2
Q

most Parkinson Syndromes are associated with ______ ______ ______

A

idiopathic Parkinson’s Disease

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3
Q

how is idiopathic Parkinson’s disease described? (2)

A

chronic
slowly progressive

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4
Q

what is a definite risk factor for Parkinson’s disease?

A

old age

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5
Q

what are 2 possible protective effects of Parkinson’s disease?

A

drinking alcohol
smoking

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6
Q

besides old age, what are 2 other risk factors for Parkinson’s disease?

A

MZ twin with early PD
family history

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7
Q

what are 4 pesticides known to have neurotoxic effects on dopamine neurons, leading to PD?

A

rotenone
maneb
dieldren
paraquate

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8
Q

what increases the life expectancy in PD patients? (2)

A

non-demented PD cases
L-dopa use

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9
Q

what are the 4 most common causes of death associated with PD?

A

pulm infection/aspiration
UTI
pulm embolism
fall/fracture complications

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10
Q

what symptom does the severity of dopamine loss best correlate with?

A

bradykinesia

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11
Q

what are the 2 dopaminergic agents for PD?

A

levodopa
carbidopa

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12
Q

what is the most effective drug for parkinsonian symptoms?

A

Levodopa

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13
Q

which drug is a dopamine precursor that crosses the BB and is converted into dopamine by dopa decarboxylase?

A

levodopa

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14
Q

what are the 4 ADR of Levodopa?

A

nausea
postural hypotension
motor fluctuations
dyskinesias

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15
Q

peripheral decarboxylase inhibitor used with levodopa

A

carbidopa

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16
Q

why is carbidopa combined with levodopa? (2)

A

decrease ADR from peripheral formation of catecholamines

increase levodopa into brain

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17
Q

drug class that inhibits an enzyme which degrades dopamine; given with levodopa to inhibit its degradation and prolong its effects

A

COMT inhibitors

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18
Q

-capone

A

COMT inhibitors

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19
Q

COMT inhibitor that does not cross the BBB, but blocks levodopa metabolism in the periphery

A

entacapone

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20
Q

COMT inhibitor that cross the BBB and has a long half-life

A

tolcapone

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21
Q

combination drug of levodopa, carbidopa, and entacapone

A

stalevo

22
Q

what is an ADR of tolcapone?

A

liver toxicity

23
Q

levodopa treats _____, rather than _____

A

symptoms
disease

24
Q

levodopa therapy for 1 year can cause:

A

dyskinesia

25
Q

levodopa therapy for 3 years can cause:

A

on-off effects; mobility + immobility

26
Q

levodopa therapy past 5 years has:

A

poor prognosis

27
Q

what are 3 reversible, acute ADR of levodopa?

A

N/V
orthostatic hypotension
arrhythmias

28
Q

what are 2 reversible, chronic ADR of levodopa?

A

dyskinesia
psych disturbance

29
Q

patients experiencing psychosis with levodopa treatment can be treated with that?

A

clozapine

30
Q

what are 2 irreversible ADR of levodopa therapy?

A

akinesia
on-off effect

31
Q

what can treat the on-off effect of levodopa therapy? (5)

A

smaller doses/more frequent intervals
drug holidays
dopamine agonists
MAO-B inhibitors
SR formulations

32
Q

what 2 drugs does levodopa interact with?

A

phenothiazines
epi in local anesthetic

33
Q

what can occur if levodopa is used with local anesthetic Epi?

A

heart arrhythmias

34
Q

what are the 3 dopamine receptor agonists?

A

pergolide
bromocriptine
pramipexole

35
Q

what are 2 features of dopamine agonists?

A

longer half-life than levodopa
no absorption delay d/t amino acids

36
Q

what drug class can delay or reduce motor fluctuations and dyskinesias associated with levodopa?

A

dopamine agonists

37
Q

what are the 5 ADR of dopamine agonists?

A

N/V/dizziness
postural hypotension
headache
dyskinesia
hallucination/paranoia/confusion

(same as levodopa, but add CNS symptoms)

38
Q

what are the 2 dopaminergic agents?

A

selegiline
amantadine

39
Q

irreversible MAO-B (mitochondrial enzyme that metabolizes dopamine) inhibitor that works in the brain

A

selegiline

40
Q

what is the use of selegiline?

A

adjunct therapy to levodopa to diminish on-off effect

40
Q

what are the 3 ADR of selegiline?

A

insomnia
hallucinations
nausea (rare)

41
Q

what drugs can selegiline interact with?

A

tricyclics
SSRIs

42
Q

an antiviral agent that promotes the release and delays uptake of dopamine

A

amantadine

43
Q

what are the 4 uses of amantadine?

A

tremor
bradykinesia
rigidity
dyskinesia

44
Q

what are the 2 ADR of amantadine?

A

autonomic
psych

45
Q

why are anticholinergics used for PD?

A

dopamine depletion lead to overactive acetylcholine; used to treat cholinergic symptoms

46
Q

what are the 3 anticholinergics?

A

“Ben(ztropine) Tri(hexyphenidyl) to treat cholinergic symptoms in Ethan (Ethopropazine)”

benztropine
trihexyphenidyl
ethopropazine

47
Q

what are the uses of anticholinergics?

A

initial stages
adjunctive

48
Q

what 2 symptoms do anticholinergics treat?

A

tremor
rigidity

49
Q

what are 5 ADR of anticholinergics?

A

dry mouth
sedation
delirium
constipation
urinary retention

Pharmacology 2 (22 decks)

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