Pharm

Question 1

Ropinirole

Answer 1

D2 R agonist used to tx PD

Question 2

Pramipexole

Answer 2

D R agonist used to tx PD, relative D3 affinity

Question 3

Rotigotine

Answer 3

D R agonist used to tx early PD. Skin patch

Question 4

in PD, the ____ pathway predominates

Answer 4

indirect

Question 5

5 strategies in PD pharm therapy

Answer 5

replace DA, stim D Rs, enhance DA release, inhibit DA metabolism, alter DA/Ach balance

Question 6

Selegiline

Answer 6

MAO-B inhibitor. Tx PD. May have neuroprotective effects. Used when Ldopa response has declined. Little effect when used alone

Question 7

Rasagiline

Answer 7

more potent MAO-B inhibitor. For combined therapy with levodopa in late stage PD or alone early in PD

Question 8

Do not take meperidine, TCAs, SSRIs with

Answer 8

Selegiline

Question 9

Metabolized by CYP1a2

Answer 9

Ropinirole - D R agonist (D2)

Question 10

COMT inhibitors

Answer 10

entacapone, tolcapone - inhibit DA metab. increase bioavail of Ldopa, reduces fluctuations in response

Question 11

only has peripheral COMT inhib effect

Answer 11

entacapone. Tolcapone is central and peripheral

Question 12

AE tolcapone

Answer 12

increased liver enzymes and hepatic failure

Question 13

Muscarinic antagonists used in PD

Answer 13

benztropine, diphenhydramine, trihexyphenidyl - early PD or adjunct to Ldopa

Question 14

AE of musc antags for PD

Answer 14

typical anticholinergic effects, drows, inattention, confusion, delusions, halluc, mood change

Question 15

Contraindications of musc antags used in PD

Answer 15

prostatic hyperplasia, OBD, glaucoma, avoid use with other drugs with antimusc effects (TCAs, antihistamines)

Question 16

calcium channel blocker of the dihydropyridine class. It is usually prescribed for the treatment of high blood pressure in order to reduce the risk of stroke and heart attack. More recent research in animal models suggests that isradipine may have potential uses for treating Parkinson’s disease

Answer 16

Isradipine

Question 17

Drugs for Huntingtons are aimed at

Answer 17

treating the depression - Fluoxetine, Carbamazepine. Reserpine and tetrabenazine (central dopamine depleting agents) may help with chorea - increase act of indir pathway by blocking D2)

Question 18

mu R endogenous opioid peptide

Answer 18

endorphins > enkeph > dynorph

Question 19

delta R endogenous opioid peptide

Answer 19

enkephalin

Question 20

kappa R endogenous opioid peptide

Answer 20

dynorphin

Question 21

main reservoir for opiate distribution

Answer 21

skeletal muscle

Question 22

AE of opioids that do not demonstrate tolerance

Answer 22

miosis, constipation, convulsions. Moderate for bradycardia

Question 23

increased CNS depression with opioids when given with

Answer 23

sedative hypnotics, antipsychotic tranquilizers, monoamine oxidase inhibitors (increased risk hyperpyrexic coma)

Question 24

codeine converted to morphine via

Answer 24

CYP2D6

Question 25

lack active metabolites and could be considered in the setting of renal failure

Answer 25

hydromorphone and fentanyl

Question 26

opioids work in

Answer 26

ventral tegmental neurons which lead to increased dopaminergic activation in the nucleus accumbens

Question 27

tox of capsaicin

Answer 27

increased pain, burning eyes or mucus membranes

Question 28

tox of cod liver

Answer 28

increased bleeding risk oral anti-coag, additive with antihypertensive, increased blood sugar

Question 29

tox of devil's claw

Answer 29

adversely affects acid inhibiting, BP and CV drugs

Question 30

tox of epsom salts

Answer 30

GI irritation, drug interactions affecting excretion and skeletal muscle relaxants

Question 31

tox of white willow

Answer 31

contains salicyclates, potential interaction with anticoagulants, antiplatelet and oral drugs