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Brain Power: Neuropharmacology > Movement > Flashcards

Flashcards in Movement Deck (21):
1

What are the most notorious anti-psychotic drug classes for drug induced parkinsonism?

Butyrophenones and phenothiazines

2

What are the 2 reasons why dopamine is not effective for PD in its pure form?

1. Dopamine has low bioavailability
2. Dopamine does not readily cross the BBB

3

What enzyme does carbidopa inhibit?

Dopa decarboxylase in the peripheral tissues

4

What are the 2 enzymes in the periphery are inhibited by Entacapone and Carbidopa to prevent metabolism of Levodopa before it makes it into the brain?

Entacapone and tolcapone: COMT Catecholamine-O-methyltransferase
Carbidopa: Dopa decarboxylase

Tolcapone acts in both the central and peripheral compartments. Entacapone acts only in the periphery similar to carbidopa

5

How does pramipexole affect the sleep pattern of PD patients?

They may cause an uncontrollable urge to sleep

6

Indicate which dopamine agonist receptor the following drugs act on
1. Bromocriptine
2. Pramipexole
3. Ropinirole

1. D2
2. D3
3. D2

7

Why is bromocriptine not a first line medication for PD?

It is an ergot and can causes erythromelalgia and pulmonary infiltrates.

8

What PD medication has onset of action in 10 minutes?

Apomorphine

9

What are the two commonly used MAO-B inhibitors, which of them is more potent and which is known to cause serotonin syndrome when used with SSRI's

Rasagiline more potent
Selegiline serotonin syndrome

10

Which COMT inhibitor can act both centrally and peripherally?

Tolcapone. Entacapone periphery only

BUT tolcapone causes liver damage-- need consent prior to use out of many markets already

11

Which group of PD drugs causes the urine to turn orange?

Entacapone

12

What are the 3 theoretical MOA of amantadine?

1. Increase in dopamine synthesis and release
2. Inhibition of dopamine uptake
3. NMDA antagonist

13

What are the two adverse effects that are specific to amantadine among PD drugs?

Peripheral edema and livedo reticularis

14

What is the MOA of the following drugs, benztropine, biperiden and ophenadrine? What PD symptoms/ signs do they address the best?

Anticholinergics address tremor and rigidity but very little effect on bradykinesia

15

What movement disorder can be treated by the following: haloperidol, clonidine and pimozide?

Tics

16

What are the top 2 first line medications for essential tremor?

Beta blockers
Primidone

17

What is the first line treatment of Wilson Disease?

Penicillamine a chelating agent

18

What medication can be given for restless legs syndrome?

Pramipexole and Ropinirole (Dopaminergic therapy)

19

What CA may be
activated by levodopa?

Melanoma

20

What eye condition is levodopa a relative contraindication?

Because of its mydriatic action it can cause increase in IOP therefore relative CI to open angle glaucoma but ABSOLUTE CONTRAINDICAITON TO ANGLE CLOSURE GLAUCOMA

21

Why would tetrabenzine and haloperidol be considered medications for Huntington's disease?

T: Deplete dopamine
H: Block dopaminergic receoptors