Parkinson's Disease Flashcards Preview

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Flashcards in Parkinson's Disease Deck (31):
1

This is the immediate precursor to dopamine. It is the gold standard for treatment of Parkinson's. Crosses the BBB

Levodopa

2

This drug inhibits aromatic L-amino acid decarboxylase in the periphery

Carbidopa

3

What are 3 strategies to address wearing off of Levodopa/Carbidopa

-increase dose or dose number
-add a dopamine agonist
-use a COMT inhibitor

4

ADRS are N/V/anorexia, tachycardia, arrhythmias, visual and auditory hallucinations, depression, mania, anxiety, dyskinesia

Levodopa/Carbidopa

5

Drug interactions with vitamin B6 (pyridoxine), MAO inhibitors, antipsychotics

Levodopa/Carbidopa

6

This class of drugs have reduced risks of motor complications and dyskinesias compared to Levodopa/Carbidopa

Dopamine agonists

7

These two dopamine agonists are FDA indicated as monotherapy

Pramipexole
Ropinirol

8

This class of drugs can be neuroprotective. It decreases autooxidation and free radical formation in the brain. Reduces levodopa requirements

Dopamine agonists

9

ADRs include N/V, orthostasis, psychosis, narcolepsy

Dopamine agonist

10

Can cause increased risk of compulsive gambling due to stimulation of dopamine release in the mesolimbic pathway

Dopamine agonists

11

This dopamine agonist has a 3 hour half life, high first pass metabolism and is highly protein bound

Bromocriptine

12

This dopamine agonist has an 8-12 hour half life and is renally excreted

Pramipexole

13

Adverse effects include sedation, hypotension, delusions or psychosis, dyskinesias, N/V, and leg edema

Dopamine agonists

14

This dopamine agonist is transdermal, has a high affinity for DA receptor subtypes, and can be used as monotherapy or adjunct therapy

Rotigotine

15

AEs of this dopamine agonist include application site rxns, nausea, somnolence, sudden onset of sleep, and brief LOC while driving

Rotigotine

16

This MAOB inhibitor can extend the time before l-dopa is needed by 9 months and can extend its action for up to an hour

Selegiline

17

ADRs include insomnia, jitteriness, HTN, worsen preexisting hallucinations and delusions. Can cause a rare serotonin syndrome with concomitant SSRI treatment

Selegiline

18

This is transdermal Selegiline

Emsam

19

This is a selective, irreversible MAO-B inhibitor that is 5x more potent than Selegiline

Rasagiline

20

2 Parkinsons drugs metabolized by CYP 1A2

Ropinirole, Rasagiline

21

This drug is used as an adjunct to L-dopa, is more efficacious than anticholinergic agents, and relieves symptoms of bradykinesia, rigidity, and tremor

Amantidine

22

This drug has fewer side effects than L dopa or anticholinergic agents. Can cause hallucinations. confusion, and nightmares when administered with an anticholinergic

Amantidine

23

ADRs include insomnia, dizziness, and slurred speech. CAUTION in patients with renal disease

Amantidine

24

Indicated for tx in pts with PD experiencing end of dose wearing off with l-dopa

COMT inhibitors

25

These agents have NO ROLE AS MONOTHERAPY

COMT inhibitors

26

This COMT I is highly protein bound and readily absorbed. You need to do strict LFT monitoring, DC if signs of liver failure (there is even an informed consent on package insert)

Tolcapone

27

Can cause delayed onset diarrhea and brownish orange fluid discoloration, and orthostasis

Tolcapone

28

This COMT I causes diarrhea and orthostasis, brownish-orange urine discoloration, but NO evidence of hepatotoxicity

Entacapone

29

This drug is a combo of carbidopa, levodopa, and entacapone

Stalevo

30

These 2 anticholinergic drugs arent as effective as l-dopa but CAN be effective against tremor and dystonic features. Ineffective against bradykinesia

Trihexphenidyl
Benzotropine

31

ADRS: dry mouth, blurred vision, constipation, urinary retention, sedation memory impairment, confusion, dysphoria, hallucinations

Anticholinergics