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Flashcards in pharm of parkinson Deck (31)
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1
Q
drugs used for parkinson
A
1. L-dopa and carbidopa
2. dopamine receptor agonists
3. anticholinergic drugs
4. monoamine oxidase inhibitors (MAOI)
5. Carechol-o-methyl transferase inhibitors (COMTI)
6. amantidine
2
Q
amantidine function
A
1. increases availability of endogenous dopamine in caudate and putamen
2. glutamate receptor (NMDA) antagonist
3
Q
COMTI function
A
inhibits COMT, part of pathway of L-DOPA and dopamine
4
Q
L-DOPA
A
is an intermediate product in the synthesis of dopamine endogenously
5
Q
Carbidopa function:
A
cannot cross the BBB but can inhibit degradation of L-DOPA in the gut and liver by blocking dopamine decarboxylase.
6
Q
Give L-DOPA with carbidopa:
A
you deliver a high dose of L-DOPA to the brain where it can be converted to dopamine in the basal ganglia.
7
Q
The D2 receptor is on the
A
indirect pathway and is Gi so it suppresses the indirect pathway, which is normally inhibitory to the thalamus.
8
Q
L-DOPA in Parkinson’s
A
Parkinson's is disease of too little dopamine synthesis, giving L-DOPA can help replenish some of the missing dopamine in the brain.
9
Q
L-DOPA absorption
A
1. orally
2. crosses the blood brain barrier.
10
Q
dopamine receptor agonists function
A
1. bind to D2 receptors
2. agonize dopamine effects
3. do not replace L-DOPA, so have longer half lives
11
Q
anticholinergic drug function
A
1. when there is a loss of dopamine, there is an overactivity of cholinergic interneurons in putamen and caudate (DA inhibits ACh)
2. block muscarinic receptors
3. less effective than L-DOPA
12
Q
MAOI function in parkinson
A
1. MAO is responsible for breaking down DA into DOPAC
2. By inhibiting this action, the effects of DA can be potentiated
3. MAO-A and B
13
Q
L-DOPA (with carbidopa)
Class
A
Endogenous precursor to DA
14
Q
L-DOPA (with carbidopa) SE
A
1. Acute: Nausea, hypotension, depression and psychosis

2. Chronic: dyskinesia and psychosis
15
Q
Bromocriptine Class
A
D2 receptor agonist
16
Q
Bromocriptine SE
A
1. nausea
2. changes in mentation
3. sudden onset sleep
17
Q
Pergolide Class
A
D2receptor agonist (also D1 and 5HT)
18
Q
Pergolide SE
A
1. nausea
2. changes in mentation
3. sudden onset sleep
19
Q
Pramipexole class
A
D2 receptor agonist (also D3 and D4)
20
Q
Pramipexole SE
A
1. nausea
2. changes in mentation
3. sudden onset sleep
21
Q
Ropinirole Class
A
D2 receptor agonist (also D3 and D4)
22
Q
Ropinirole SE
A
1. nausea
2. changes in mentation
3. sudden onset sleep
23
Q
Cabergoline Class
A
D2 receptor agonist (also D3, D4 and 5HT)
24
Q
Cabergoline SE
A
1. nausea
2. changes in mentation
3. sudden onset of sleep
25
Q
Cabergoline half life
A
65 hours
26
Q
Amantidine class
A
Glutamate Receptor Antagonist
27
Q
Amantidine SE
A
Increases availability of endogenous DA
28
Q
Trihexyphenidyl Class
A
Anticholinergic
29
Q
Trihexyphenidyl SE
A
1. Swallowing difficulties
2. Decreased bowel motility
3. Urinary retention
30
Q
Benztropine Class
A
Anticholinergic
31
Q
Benztropine SE
A
1. swallowing difficulties
2. decreased bowel motility
3. urinary retention