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Flashcards in Neurodegenerative Disease Deck (45)
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1

Levodopa

Parkinsons

2

Levodopa MOA

metabolic precursor to Dopamine. Becomes dopamaine to restore post-synaptic concentration of dopamine. Activates post-synaptic D1 and D2 receptors

3

Carbidopa

inhibits dopa decarboxylase to allow levodopa to enter the BBB

4

Levodopa contraindications

MAOI use, history of malignant melanoma, narrow angle glaucoma. Monitor LFT

5

Levodopa ADR

Dyskinesias, "on-off" effect, Nausea, anorexia, hypotension, confusion, insomnia, nightmares, schizophrenic like syndrome

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Dopamine Agonists

apomorphine, bromocriptine, pergolide, pramipexole, ropinirole, rotigotine

7

Dopamine Agonists ADR

N/V, anorexia, hypotension, cardiac arrythmias, HA, confusion, hallucinations, sedation, pulmonary fibrosis

8

Ergot Dopamine Agonists

Bromocriptine and Cabergoline. D2 receptor agonists

9

NonErgot Dopamine Agonists

Pramipexole, Ropinerole, Rotigotine (patch), Apomorphine

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Pramipexole indications

advanced Parkinsons and restless leg syndrome

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Ropinerole indications

monotherapy in mild parkinsons and restless leg syndrome

12

Rotigone ADR

sudden somnolence

13

Apomorphine receptor type

D1/D2

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Pramipexole receptor type

D3. some D2/D4

15

Ropinerole receptor

D2

16

Apomorphine indications

subQ injection for temporary relief of "off" periods

17

Apormorphine ADR

dyskinesias, drowsiness, sweating, hypotension

18

Selegiline MOA

monoamine oxidase- B inhibitors

19

Selegiline indications

effective as monotherapy or in combination with levodopa for parkinsons. enables reduction in levodopa

20

Selegiline ADR

blocks MAO-A at high doses, fatal hyperthermia

21

Rasagiline MOA

irreversible MAO-B inhibitor

22

Rasagiline indications

early treatment of Parkinsons and as adjunct with Levodopa

23

Rasagiline metabolism

extensive liver metabolism. metabolized at CYP1A2.

24

Rasagiline Drug interactions

meperidine, dextramethorphan, St. Johns Wort, cyclobenzaprine, ciprofloxacin

25

Catechol-O-Methyltransferase inhibitors

Tolcapone, entecapone

26

COMT inhibitors MOA

inhibits metabolism of dopamine. increase availability of Ldopa

27

COMT indications

adjunct treatment for Parkinsons with levodopa

28

COMTI ADR

increased plasma concentration of Ldop (dyskinesias, nausea, confusion), Diarrhea, abd pain, orthostatic hypotension, sleep disorders, orange urine discoloration. Tolcapone may be hepatotoxic

29

COMT pearls

do not use MAO-A and COMT together. MAO-B may be okay. Entacapone=P450 inhibitor. Taper dosing for discontinuation

30

Stalevo

Levodopa + Carbidopa + entacapone