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