Pharm Movement Disorders, Kinder I Flashcards Preview

Year 2 neuro exam 2 > Pharm Movement Disorders, Kinder I > Flashcards

Flashcards in Pharm Movement Disorders, Kinder I Deck (45):
1

What dopamine agonists are used for movement disorders

bromocriptine
pramipexole

2

what kind of drug is rasagiline

Monoamine oxidase inhibitor MAOI

3

what type of drug is entacapone

catechol o methyltransferase inhibitor

4

benztropine

antimuscarinic agent

5

resting tremor

parkinsons

6

intention tremot

essential
tremor during purposeful movement

7

chorea

irregular unpredictable involuntary muscle jerks

8

athetosis

abnormal movements which are slow and writhing

9

dystonia

sustained athetosis
regarded as abnormal postures

10

Tics

sudden involuntary coordinated abnormal movements
tend to be repetitive about face and head

11

gilles de la tourettes

chronic multiple tics

12

parkinsons

combination of rigidity, bradykinesia tremor and postural instability
other non-motor Sx

13

pathophys parkinsons

loss dopaminergic neurons in substantia nigra causing disinhibition GABAergic neurons

14

why is dopamine ineffective when given to parkinson patient

dopamine does not cross bbb
give Levodopa

15

how does levodopa enter brain

L amino acid transporter LAT

16

MOA levodopa

stimulates D2 R

17

PK levodopa

infestion of food delays absorption so take 30-60 min before a meal

18

what is carbidopa

dopa decarboxylase inhibitor
reduces peripheral metabolism of levodopa

19

use of levodopa/carbidopa

lower mortality and early initiation of parkinsons
some become less responsive to levodopa
1/3 people respond very well

20

GI effects levodopa

anorexia nausea comiting

21

prevent GI side effects levodopa

give with carbidopa

22

CV effects levodopa

postural hypotension
tachy, ventricular extrasystoles
HTN with large doses or with combination of MAOIs

23

behavioral effects levodopa

depression, anxiety, agitation, insomnia, somnolence, confusion delusions, hallucinations, nightmares, euphoria

24

80% patients on levodopa for 10 years have what side effect

dyskinesia

25

dyskinesia caused by levodopa

choreathetosis of face and distal extremitites

26

on-off phenomenon when on levodopa

off periods- akinesia
on periods- improved mobility with dyskinesia

27

levodopa with pyridoxine B6

increase extracerebral metabolism
goes away if add carbidopa

28

levodopa and MAOIs

HTN
do not give within 2 weeks of administration

29

CI levodopa

angle closure glaucoma, psychosis, active peptic ulcer disease, malignant melanoma

30

levodopa is a precursor to what

melanin

31

MOA dopamine agonists

act on postsynaptic Dopamine R

32

1st line therapy for parkinsons

dopamine agonist

33

what are the DA used for movement disorders

bromocriptine and pramipexole

34

Dopamine R bromocriptine likes

D2 agonist
it is an ergot alkaloid derivative

35

therapeutic use bromocriptine

hyperprolactinemia, prolactin secreting adenomas, acromegaly
parkinsons

36

dopamine R pramipexole likes

D3

37

dose adjustment in what patients with pramipexole

renal insufficiency

38

therapeutic use pramipexole

parkinsons
mod-severe, primary and restless leg syndrome

39

GI effects dopamine agonists

anorexia, nausea vomiting
constipation dyspepsia
reflux

40

CV effects dopamine agonists

postural hypotension
painless digital vasospasm

41

movement effects dopamine agonists

dyskinesias

42

mental disturbances from dopamine agonists

confusion, hallucinations, delusions
disorders of impulse control

43

side effects seen with bromocriptine

HA nasal congestion, increased arousal, pulmonary infiltrates, pleural and retroperitoneal fibrosis

44

weird side effect with pramipexole

uncontrollable tendency to fall asleep at inappropriate times

45

CI dopamine agonists

history of psychotic ilnesss, recent MI, active peptic ulcer disease
best avoided in peripheral vascular disease