Neurodegenerative Disease Drugs Flashcards
L-DOPA (Levodopa)
Treatment: Parkinson’s
Mechanism: Dopamine precursor that acts as replacement therapy, wears off after 3-5 years unfortunately
Side effects: Peripherally = nausea, vomiting, anorexia, cardiac arrythmias, orthostatic hypotension Centrally = hallucinations, involuntary movement (dyskinesia), mood changes and other psych
Carbidopa
Treatment for Parkinson’s with L-DOPA
Blocks L-Dopa metabolism (aromatic something) and allows for lower dose therefore reducing side effects
Entacapone
Treatment for Parkinson’s with L-DOPA and Carbidopa
Further reduces L-Dopa peripheral metabolism (catechol O-methyltransferase inhibitor)
Selegiline and Rasagiline
Parkinson’s
Both inhibit monoamine oxidase B (dopa breakdown) but Rasagiline is selective for the one in the brain
Really only work if receiving L-DOPA
Dopamine Receptor Agonists
Parkinson’s –> monotherapy early, L-DOPA synergy later
Bromocriptine: D2 and partial D1
Ropinirole: D2/3
Pramipexole: D2/3
Side Effects: Similar to L-DOPA (ie: nausea, vomit, heart) and contraindicated in people with heart or mental issues
Apomorphine
Dopamine Receptor Agonist (Parkinson’s)
Specifically for “off” periods
Muscarinic Antagonists
Benztropine and Trihexyphenidyl (Parkinson’s)
Used to block tremor and rigidity but not helpful for the bradykinesia
Amantidine
Parkinson’s
Used for the bradykinesia and rigidity
Increases dopamine release and blocks glutaminergic NMDA and cholinergic muscarinics
Acetylcholinesterase Inhibitors
Alzheimer’s Disease
Donepezil, Galantamine, Rivastigmine, Tacrine
Allows you to have increased acetylcholine in synapse
Side Effects: Tremors, Bradycardia, Nausea, Vomiting, Diarrhea and anorexia. Tacrine can be really bad (hepatotoxicity)
Memantine
Alzheimer’s
NMDA antagonist (protects neurons from Ca overload), additive benefits with Donepezil
SE: Dizzy, headache, confusion, agitation, constipation
