Parkinson disease (dopamine receptor agonists) Flashcards Preview

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Flashcards in Parkinson disease (dopamine receptor agonists) Deck (22)
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1

Dopamine receptor agonists used in PD - 5 drugs

Bromocriptine
Pramipexole
Ropinirole
Rotigotine
Apomorphine

2

Dopamine receptor agonists - MOA

Directly activate dopamine D2 receptors in the striatum.
Inhibition of the indirect neuronal pathway from the striatum to the thalamus, and increase thalamic stimulation of the motor area of the cortex.

3

When are the dopamine receptor agonists useful and why?

Advanced cases of PD.
Do not require functional dopaminergic neurons.

4

Bromocriptine - MOA

D2-agonist, D1-antagonist

5

Bromocriptine - indications

Adjunct to levodopa.
Type 2 DIA

6

Bromocriptine - adverse effects

Confusion, hallucinations, sedation, vivid dreams, dyskinesias.
Decreased prolactin levels.
Dry mouth, nausea, orthostatic hypotension.

7

Which dopamine receptor agonists activates both D2 and D3 receptors?

Pramipexole
Rotigotine

8

Which drugs for PD are also indicated for restless leg syndrome?

Pramipexole.
Ropinirole

9

Pramipexole, ropinirole - adverse effects

Dizziness
Hallucinations
Insomnia
Nausea
Vomiting
Sedation

10

Pramipexole - interactions

Cimetidine increases serum levels

11

Ropinirole - MOA

Selective D2-receptor agonist.

12

Ropinirole - interactions

Ciprofloxacin increases serum levels

13

Ropinirole, rotigotine, pramipexole - indications

Delay need for levodopa in early stages of PD. Advanced stages – reduce off period. Monotherapy

14

Rotigotine - contraindications

Sulfite sensitivity

15

Apomorphine - MOA

Dopamine receptor agonist that is chemically related to morphine

16

Apomorphine - indications

Acute, intermittent hypomobility episodes in advanced PD.

17

Apomorphine - adm

Injection only

18

Centrally acting ACh receptor antagonists used in PD

Benztropine
Trihexyphenidyl

19

Benztropine - MOA

Like all central antiACh, it decreases the relative excess of ACh and has antihistamine activity.
In addition it inhibits neuronal reuptake of dopamine.

20

Centrally acting ACh receptor antagonists - indictions in PD

Adjunct therapy for PD.
Most effective for reducing tremor.
Reduce parksonian symptoms caused by dopamine receptor antagonists.

21

Centrally acting ACh receptor antagonists - adverse effects

Agitation
Confusion
Constipation
Dry moth
Delirium
Memory loss
Urinary retention
Tachycardia

22

Centrally acting ACh receptor antagonists - interactions

Additive anticholinergic effect with antihistamines and phenothiazides