IC 14 - Pharmacology

Question 1

What is the MOA of Levodopa combination products?

Answer 1

Peripheral DOPA-decarboxylase inhibitor which prevent conversion to dopamine at peripheral sites leading to increase L-DOPA to brain

Question 2

What is one long term adverse effects of Levodopa?

Answer 2

Dyskinesia

Question 3

What are the two medications that are often combined with Levodopa?

Answer 3

Often combined with carbidopa or benserazide

Question 4

What is the MOA of Entacapone/ Tolcapone?

Answer 4

1. Blocks COMT
2. Cannot convert dopamine or L-DOPA into inactive form
3. Increase amount of L-DOPA/ Dopamine to brain

Question 5

How is Entacapone/ Tolcapone given?

Answer 5

As adjunct to levodopa or levodopa/ benserazide

Question 6

What is one side effect specific to Tolcapone?

Answer 6

Liver dysfunction

Question 7

What is the MOA of Selegiline/ Rasagiline?

Answer 7

MAOi that inhibits enzyme MAO-B leading to dopamine unable to breakdown.

Question 8

Which MAOi is efficacious as symptomatic monotherapy for Parkinson in early stage?

Answer 8

Selegiline

Question 9

What is one side effect of MAOi?

Answer 9

Nightmares, visual hallucination

Question 10

What class of drugs does Pramipexole, Pergolide and Ropinirole belongs to?

Answer 10

Erogot and non ergot derivatives

Question 11

What is one side effect of pergolide?

Answer 11

Peritoneal fibrosis

Question 12

What are the side effects of Pramipexole and Ropinirole?

Answer 12

Sedation, somnolence, daytime sleepiness

Question 13

What are the indications of dopamine receptors agonist?

Answer 13

1. Prevent or delay onset of motor complications

Question 14

Why dopamine receptors agonist preferred for young Parkinson patients?

Answer 14

Decrease dyskinesia risk as compared to giving levodopa.

Question 15

How does amantadine works for Parkinson?

Answer 15

Enhanced stored dopamine release and inhibit presynaptic uptake of catecholamine

Question 16

How can amantadine be given to patients?

Answer 16

1. Monotherapy or adjunct to levodopa

Question 17

Amantadine has ____ properties.

Answer 17

antidyskinetic

Question 18

What class of drugs does Trihexyphenidyl belong too?

Answer 18

Anticholinergic

Question 19

What are two advantages of using Trihexyphenidyl?

Answer 19

1. May control tremor
2. May be useful in treating sialorrhoea

Question 20

How can Trihexyphenidyl be given?

Answer 20

1. Symptomatic monotherapy
2. Adjunct to levodopa to treat tremors and stiffness in parkinson’s disease

Question 21

List three acetylcholinesterase inhibitors that may be used for mild demnentia.

Answer 21

Donepezil , Galantamine, Rivastigmine

Question 22

How does Donepezil , Galantamine, Rivastigmine works?

Answer 22

Inhibits acetylcholinesterase

Question 23

What is the difference in dosage form for Galantamine, Rivastigmine?

Answer 23

1. Rivastigmine: Oral, Transdermal patch form
2. Galantamine: Oral

Question 24

Rivastigmine’s t1/2 is _____ than Galantamine’s.

Answer 24

shorter

Question 25

What is the difference in terms of metabolism between Rivastigmine and Galantamine.

Answer 25

Rivastigmine: Kidney Galantamine: Liver (CYP450)

Question 26

Galantamine may act on _____ receptors in brain.

Answer 26

nicotinic

Question 27

List one acetylcholinesterase inhibitors that can be used for mod to severe dementia.

Answer 27

Memantine

Question 28

What is the drug class of memantine?

Answer 28

Non competitive NMDA receptor antagonist

Question 29

What are the side effects of memantine?

Answer 29

S/E: Hallucination, confusion, dizziness, headaches