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Flashcards in Parkinson Deck (25):
1

Dopamine blockers that worsen PD

Prochlorperazine
Phenothiazines

Butyrophenones (Haloperidol)(Droperidol)

Risperidone and Palperidone

Metoclopramide

2

Which is the preferred antipsychotic and why?

Quetiapine which has low risk of movement disorders but can also cause METABOLIC conditions like increased sugar and cholesterol

Clozapine bc of the low risk of movement but high risk of agranulocytosis and seizures

3

Which is the most beneficial treatment?

Levodopa which is paired with Carbidopa bc of its ability to prevent peripheral metabolism which would destroy most of the drug before it crosses the BBB

4

what does COMT do for PD pateints?

its an inhibitor of the enzyme so it will allow more drug to pass BBB

5

Which drugs prevent the breakdown of Dopamine?

MAO-B

6

Centrally acting Anti-cholinergics are most effective in these patients?

Young patients with Tremors.

7

Carbidopa MOA

Inhibits dopa decarboxylase preventing peripheral metabolism

8

How many mg of Carbidopa are required to inhibit dopa decarboxylate

70-100mg

9

Which Dopamine agonist can be cut and which can be sprinkled?

Cut- Sinamet CR
Sprinkled- Rytary

10

If a patient has PD and test positive in a cooms test, what next?

Discontinue the drugs

11

SE and Notes for Carbidopa/Levodopa

Nausea/Dizziness, Discolor urine, unusual sex urges, priapism

Notes- long term use can lead to fluctuations in response and dyskinesia.

Titrate cautiously

12

COMT moa? Drugs/dose?

Increase the duration of Levodopa

Entecapone (Comtan) 200mg PO
or Sinemet+Entecapone (Stalevo)

13

Name some Dopamine agonist and what other indications?

Pramipexole (Mirapex)
Ropinirole (Requip)
Rotigotine (Neurpro) PATCH

Restless leg syndrome

14

Dopamine agonist SE's and Notes

Somnolence, Orthostasis, Hallucinations and Dyskinesia

Neupro- rotate every 2 weeks and avoid if allergic to Sulfites

15

Dopamine agonist injectable for severe patients.. and tal about CI/SE/NOTES

Apokyn (Apomorphine)

Dose is written in ML, last 45-90 min

CI- Dont use with 5HT3 (Zofran) can cause severe hypotension and loss of consciousness

SE: hypotension, SEVERE N/V

Notes: for emesis prevention give TIGAN (trimethobenzamide)

16

What are some Drug interactions with Sinemet?

separate with MAOI for 2 weeks
Iron and protein rich foods

17

Amatadine CI/Warning/SE and MOA

CI with CrCl<15
Warning: Somnolence and Psychosis

SE: Dizziness, Orthostatic hypotension

MOA- Blocks the reuptake of Dopamine in the synapse so it can increase more dopamine in the presynaptic fibers

18

Selective MAO-B CI/Warning/and MOA

MOA- Blocks the breakdown Dopamine and mostly used at adjunctive therapy

Warnings include Serotonin syndrome and hypertension

19

Which MAOB should not be taken at night? and which is the only indicated for monotherapy

Selegiline and Resegiline (AZILECT)

20

Centrally acting anticholinergic medications MOA and SE

Benztropine (Cogentin)
Anticholinergic and Antihistamine effects

SE: Dry mouth, urinary retention, constipation, blurred vision, confusion, somnolence.

21

Droxidopa (Northera) has this MOA and SE

Alpha/Beta Agonist

SE include syncope, falls and HA

22

What interacts with cariboda/levodopa?

Protein, Iron and High fat foods.

23

Counseling points for Neupro patch?

Drink lots for fluids, avoid sunlight, wait at least 14 days before reapplying it in the same place.

24

Xadago CI and class

MAOB (Safinamide)

CI- Severe hepatic impairment

25

Amantadine is indicated for what treatment?

PD

Prophylactic Influenza A