parkinsons Flashcards
parkinsons
substance nigra diess that usually produce dopamine
coordinated function
major symptomes
TRAP
tremor
rigidity
akinesia
postural
drugs that can make PD worse
phenothiazines
butyrophenones(haloperidol, droperidol)
1st gen anti psych - risperidone paliperidone lowest risk quetiapine
metochlopramine
conditions during PD
depressions- SSRI SNRI tricycline secondary
psychosis - quetiapine preffered , clozapine REMS
drug tx
levodopa
carbidopa to prevent peripheral metabolism of levodopa
dopamine agonists - COMT and MAO-b inhibitors
centrally acting anticholinergics in young pts
amatadine
carbidopa/levodopa
sinemet 25/100 TID
50/200 for DR BID can be cut in hlaf
rytary can be sprinkled
AE of Sinemet
not with MAO iwithin 14 days
nausea dizziness orthostaiss, dykinesias, hallucinations, psychosis
can cause brown black urine ssaliva or sweat
sexual urges and priapism
do not discontinue abruptly
COMPT inhibitors
MOA increase duration of levodopa inhibits COPT to prevent peripheral conversion of levodopa
200mg PO with Sinemet
entacapone (comptan)
dopamine agonist
pramipexole (mirapex)
ropinorole requip
rotigotine Neupro patch
neupro
apply once daily same time but not same site
remove before MRI
**SULFITE allergy
pramipexole
mirapex
somnolence day time sleep
orhtostasis, hallucinations dyskinesias
dopamine agonist injections
apomorphine (apokyn
inje
start in a medical office
do not use with serotonin antagonists
severe nausea vomiting hypotensiion
what are some other drugs for PD
amantadine
select mao inhibitors- selegline ,rasagline safinamaide
selegline
zelapar
rasagline
azilect
