F-Chapter 8: Drugs for Neurodegenerative Diseases Flashcards
(10 cards)
Which one of the following combinations of antiparkin
sonian drugs is an appropriate treatment plan?
A. Amantadine, carbidopa, and entacapone.
B. Levodopa, carbidopa, and entacapone.
C. Pramipexole, carbidopa, and entacapone.
D. Ropinirole, selegiline, and entacapone.
E. Ropinirole, carbidopa, and selegiline
B. To reduce the dose of levodopa and its peripheral side effects, the peripheral decarboxylase inhibitor, carbidopa, is coadministered. As a result of this combination,
more levodopa is available for metabolism by catechol-O- methyltransferase (COMT) to 3-O-methyldopa, which competes with levodopa for the active transport processes into the CNS. By administering entacapone (an inhibitor of COMT), the competing product is not formed, and more levodopa enters the brain. The other choices arenot appropriate, because neither peripheral decarboxylase nor COMT
monoamine oxidase metabolizes amantadine or the direct-acting dopamine agonists, ropinirole and pramipexole.
Peripheral adverse effects of levodopa, including
nausea, hypotension, and cardiac arrhythmias, can be
diminished by including which of the following drugs in
the therapy?
A. Amantadine.
B. Ropinirole.
C. Carbidopa.
D. Tolcapone.
E. Pramipexole.
C. Carbidopa inhibits the peripheral
decarboxylation of levodopa to dopamine, thereby dimin
ishing the gastrointestinal and cardiovascular side effects of
levodopa. The other agents listed do not ameliorate adverse
effects of levodopa.
Which of the following antiparkinsonian drugs may cause
vasospasm?
A. Amantadine.
B. Bromocriptine.
C. Carbidopa.
D. Entacapone.
E. Ropinirole.
B. Bromocriptine is a dopamine receptor agonist that may cause vasospasm. It is contraindicated in patients with peripheral vascular disease. Ropinirole directly
stimulates dopamine receptors, but it does not cause vasospasm. The other drugs do not act directly on dopamine receptors.
Modest improvement in the memory of patients with
Alzheimer’s disease may occur with drugs that increase
transmission at which of the following receptors?
A. Adrenergic.
B. Cholinergic.
C. Dopaminergic.
D. GABAergic.
E. Serotonergic.
B. AChE inhibitors, such as rivastigmine, increase cholinergic transmission in the CNS and may cause a modest delay in the progression of Alzheimer’s disease. Increased transmission at the other types of receptors listed does not result in improved memory.
Which medication is a glutamate receptor antagonist that
can be used in combination with an acetylcholinesterase
inhibitor to manage the symptoms of Alzheimer’s disease?
A. Rivastigmine.
B. Ropinirole.
C. Fluoxetine.
D. Memantine.
E. Donepezil.
D. When combined with an acetylcholinesterase inhibitor, memantine has modest efficacy in keeping patients with Alzheimer’s disease at or above baseline for at least 6 months and may delay disease progression.
Which of the following agents is available as a patch
for once-daily use and is likely to provide steady drug
levels to treat Alzheimer’s disease?
A. Rivastigmine.
B. Donepezil.
C. Memantine.
D. Galantamine.
E. Glatiramer.
A. Rivastigmine is the only agent available as a transdermal delivery system for the treatment of Alzheimer’s disease. It may also be used for dementia associated with Parkinson’s disease.
Which of the following is the only medication that is
approved for the management of amyotrophic lateral
sclerosis?
A. Pramipexole.
B. Selegiline.
C. Galantamine.
D. Riluzole.
E. Glatiramer.
D. Riluzole continues to be the only agent FDA approved for the debilitating and lethal illness of ALS. It is used to, ideally, delay the progression and need for ventilator support in severe patients.
Which of the following medications reduces immune
system–mediated inflammation via inhibition of
pyrimidine synthesis to reduce the number of activated
lymphocytes in the CNS?
A. Riluzole.
B. Rotigotine.
C. Teriflunomide.
D. Dexamethasone.
C. Teriflunomide is believed to exert its disease modifying and anti-inflammatory effects by inhibiting the enzyme dihydro-orotate dehydrogenase to reduce pyrimidine synthesis.
Which of the following agents may cause tremors as a side effect and, thus, should be used with caution in patients with Parkinson’s disease, even though it is also indicated for the treatment of dementia associated with Parkinson’s disease?
A. Benztropine.
B. Rotigotine.
C. Rivastigmine.
D. Dimethyl fumarate.
C. Though rivastigmine is an acetylcholinesterase inhibitor, which can cause tremors as an adverse effect, its use is not contraindicated in patients with Parkinson’s disease, as this agent is also the only medication approved for dementia associated with Parkinson’s disease. It should be used with caution, as it may worsen the parkinsonian-related tremors. A risk–benefit discussion should occur with the patient and the caregiver before rivastigmine is used.
Which of the following agents exerts its therapeutic effect in multiple sclerosis via potassium channel blockade?
A. Dalfampridine.
B. Donepezil.
C. Riluzole.
D. Bromocriptine.
A. Dalfampridine is a potassium channel blocker and is the only agent that is indicated to improve walking speed in patients with MS.
