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Year 2 neuro exam 2 > Pharm Movement Disorders, Kinder I > Flashcards

Pharm Movement Disorders, Kinder I Flashcards

1
Q

What dopamine agonists are used for movement disorders

A

bromocriptine

pramipexole

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2
Q

what kind of drug is rasagiline

A

Monoamine oxidase inhibitor MAOI

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3
Q

what type of drug is entacapone

A

catechol o methyltransferase inhibitor

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4
Q

benztropine

A

antimuscarinic agent

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5
Q

resting tremor

A

parkinsons

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6
Q

intention tremot

A

essential

tremor during purposeful movement

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7
Q

chorea

A

irregular unpredictable involuntary muscle jerks

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8
Q

athetosis

A

abnormal movements which are slow and writhing

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9
Q

dystonia

A

sustained athetosis

regarded as abnormal postures

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10
Q

Tics

A

sudden involuntary coordinated abnormal movements

tend to be repetitive about face and head

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11
Q

gilles de la tourettes

A

chronic multiple tics

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12
Q

parkinsons

A

combination of rigidity, bradykinesia tremor and postural instability
other non-motor Sx

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13
Q

pathophys parkinsons

A

loss dopaminergic neurons in substantia nigra causing disinhibition GABAergic neurons

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14
Q

why is dopamine ineffective when given to parkinson patient

A

dopamine does not cross bbb

give Levodopa

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15
Q

how does levodopa enter brain

A

L amino acid transporter LAT

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16
Q

MOA levodopa

A

stimulates D2 R

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17
Q

PK levodopa

A

infestion of food delays absorption so take 30-60 min before a meal

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18
Q

what is carbidopa

A

dopa decarboxylase inhibitor

reduces peripheral metabolism of levodopa

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19
Q

use of levodopa/carbidopa

A

lower mortality and early initiation of parkinsons
some become less responsive to levodopa
1/3 people respond very well

20
Q

GI effects levodopa

A

anorexia nausea comiting

21
Q

prevent GI side effects levodopa

A

give with carbidopa

22
Q

CV effects levodopa

A

postural hypotension
tachy, ventricular extrasystoles
HTN with large doses or with combination of MAOIs

23
Q

behavioral effects levodopa

A

depression, anxiety, agitation, insomnia, somnolence, confusion delusions, hallucinations, nightmares, euphoria

24
Q

80% patients on levodopa for 10 years have what side effect

A

dyskinesia

25
Q

dyskinesia caused by levodopa

A

choreathetosis of face and distal extremitites

26
Q

on-off phenomenon when on levodopa

A

off periods- akinesia

on periods- improved mobility with dyskinesia

27
Q

levodopa with pyridoxine B6

A

increase extracerebral metabolism

goes away if add carbidopa

28
Q

levodopa and MAOIs

A

HTN

do not give within 2 weeks of administration

29
Q

CI levodopa

A

angle closure glaucoma, psychosis, active peptic ulcer disease, malignant melanoma

30
Q

levodopa is a precursor to what

A

melanin

31
Q

MOA dopamine agonists

A

act on postsynaptic Dopamine R

32
Q

1st line therapy for parkinsons

A

dopamine agonist

33
Q

what are the DA used for movement disorders

A

bromocriptine and pramipexole

34
Q

Dopamine R bromocriptine likes

A

D2 agonist

it is an ergot alkaloid derivative

35
Q

therapeutic use bromocriptine

A

hyperprolactinemia, prolactin secreting adenomas, acromegaly

parkinsons

36
Q

dopamine R pramipexole likes

A

D3

37
Q

dose adjustment in what patients with pramipexole

A

renal insufficiency

38
Q

therapeutic use pramipexole

A

parkinsons

mod-severe, primary and restless leg syndrome

39
Q

GI effects dopamine agonists

A

anorexia, nausea vomiting
constipation dyspepsia
reflux

40
Q

CV effects dopamine agonists

A

postural hypotension

painless digital vasospasm

41
Q

movement effects dopamine agonists

A

dyskinesias

42
Q

mental disturbances from dopamine agonists

A

confusion, hallucinations, delusions

disorders of impulse control

43
Q

side effects seen with bromocriptine

A

HA nasal congestion, increased arousal, pulmonary infiltrates, pleural and retroperitoneal fibrosis

44
Q

weird side effect with pramipexole

A

uncontrollable tendency to fall asleep at inappropriate times

45
Q

CI dopamine agonists

A

history of psychotic ilnesss, recent MI, active peptic ulcer disease
best avoided in peripheral vascular disease

Year 2 neuro exam 2 (23 decks)

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