Dopaminergic agents

Question 1

Crosses BBB ans is converted to dopamine–improves nigrostriatal functioning

Answer 1

Levodopa

Question 2

What drugs are contraindicated with the use of levodopa?

Answer 2

MAO-A inhibitors

Question 3

What are the side effects of Levodopa

Answer 3

Dyskinesias
Hypotension
Nausea
Anxiety
Fatigue

Question 4

What drug is given with Levodopa, which inhibits peripheral conversion of L-DOPA to dopamine–does NOT cross BBB

Answer 4

Carbidopa–Aromatic amino acid decarboxylase inhibitor

Question 5

NE-DA reuptake inhibitor used for the treatment of Parkinson’s

Answer 5

Bupropion

Question 6

What is the mechanism of Bupropion?

Answer 6

Blocks DA transporter (DAT)–increases DA in synpase

Question 7

Stimulant used for the treatment of ADHD

Answer 7

Dextroamphetamine and lisdexamfetamine

Question 8

What is the mechanism of action of Dextroamphetamine and lisdexamfetamine?

Answer 8

Stimulants–block dopamine transporter and increase VMAT2

Question 9

What are the major side effects of dextramphetamine and lisdexamfetamine?

Answer 9

NE and DA side effects
Weight loss
Addiction

Question 10

Stimulants used for Fatigue due to narcolepsy, apnea, shiftwork. They work by increasing histamine activity in the tuberomammilary nucleus

Answer 10

Modafinil and Armodafinil

Question 11

MAO-B inhibitors that prevent the breakdown of DA and are used in Early parkinson’s?

Answer 11

Selegiline–also used for depression

Rasagiline

Question 12

What are the side effects of the MAO-B inhibitors selgiline and rasagiline?

Answer 12

Hypotension, dizziness, insomnia, weight gain

Question 13

MAOi’s that irreversibly inhibit both MAO-A and MAO-B and are used for depression?

Answer 13

Tranylcypromine
Isocarboxazid
Phenelzine

Question 14

What are the side effects of tranylcypromine, isocarboxazid, and phenelzine?

Answer 14

MAOi’s

Hypotension, dizziness, insomnia, weight gain

Also cause–cheese effect—> HTN crisis–with tyramine rich foods

And serotonin syndrome if given with SSRI

Question 15

COMT inhibitors that prevent DA breakdown and are used for Parkinson’s?

Answer 15

Entacapone and Tolcapone

Question 16

Used for mild parkinson’s, RLS, and hyperprolactinemia and works through increasing DA activity by Ergot D2 receptor agonist activity…

Answer 16

Bromocriptine

Question 17

Selective D2 receptor agonist used for Mild parkinson’s and RLS. Less effective drugs with motor symptoms of PD.

Answer 17

Pramipexole and Ropinerole

Question 18

What is apomorphine used for and what is its mechanism of action?

Answer 18

Mild parkinsons and RLS

Increases DA activity through D2 receptor agonist activity

Question 19

What is contraindicated with the use of apomorphine?

Answer 19

Serotonin receptor antagonists

Question 20

D2 and D3 receptor agonist used for Schizophrenia and depression?

Answer 20

Aripiprazole

Question 21

What is the 2nd line of treatment for mild parkinson’s and also used for the treatment of influenza?

Answer 21

Amantadine – antiviral

Question 22

Blocks VMAT and is used for HTN?

Answer 22

Reserpine

Question 23

Blocks VMAT and is used for Huntington’s Chorea

Answer 23

Tertrabenazine

Question 24

Anticholinergics used in early parkinson’s that reduce the EPS parkinsonian side effects

Answer 24

Benztropine and Trihexiphenidyl

Question 25

What are the side effects seen with Benztropine and Trihexiphenidyl?

Answer 25

Typical anticholinergic--Dry mouth, blurred vision, racing heart, constipation, confusion, delirium, hallucinations

Question 26

Antihistamine that has anticholinergic properties used to reduce the EPS Parkinsonian side effects?

Answer 26

Diphenhydramine

Question 27

What are the side effects seen with diphenhydramine?

Answer 27

Typical anticholinergic--Dry mouth, blurred vision, racing heart, constipation, confusion, delirium, hallucinations

Question 28

First generation antipsychotics--low potency that are non-selective D2 receptor antagonist and are used for psychosis seen with schizophrenia?

Answer 28

Chlorpromazine and Thioridazine

Question 29

What are the side effects of Chlorpromazine and Thioridazine?

Answer 29

EPS Fatigue Weight gain Orthostasis--a1 antagonism Tardive dyskinesia with chronic use

Question 30

First generation antipsychotics--high potency that are non-selective D2 receptor antagonist used for psychosis seen with schizophrenia and movement disorder in Huntingtons?

Answer 30

Fluphenazine Thiothixine Haloperidol

Question 31

What are the side effects of Fluphenazine, thiothixine and haloperidol?

Answer 31

Non-selective D2 receptor antagonist EPS NMS Tardive dyskinesia with chronic use

Question 32

Which 2nd generation antipsychotic is used for refractory schizophrenia and has the side effect of agranulocytosis?

Answer 32

Clozapine

Question 33

D2 and D1, D4 receptor antagonist and 5HT2a receptor antagonist used for refractory schizophrenia?

Answer 33

Clozapine

Question 34

2nd generation antipsychotics used for the treatment of psychosis, mania, and aggression and have more metabolic complications?

Answer 34

Olanzapine Quetiapine Asenapine

Question 35

What are the side effects of the 'Pines'?

Answer 35

Suicide risk in ages less than 25 Metabolic syndrome greater than dones TD/EPS less than dones Stroke in dementia patients

Question 36

2nd generation Antipsychotics used for the treatment of psychosis, mania, aggression and have fewer metabolic complications but more EPS?

Answer 36

``` Risperidone Ziprazidone Paliperidone Iloperidone Lurasidone ```

Question 37

What is the mechanism of action of the pines?

Answer 37

D2 receptor antagonist, 5HT2a receptor agonist

Question 38

What are the side effects of the 'dones'?

Answer 38

Suicide risk in ages less than 25 Metabolic syndrome less than pines TD/EPS more than pines Stroke in dementia patients