Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Essentials 1.3 Drugs > Week 5 > Flashcards

Week 5 Flashcards

Parkinson's Disease Tx, Dementia Tx, and Antipsychotic Medication List (63 cards)

Start Studying
1
Q

What Parkinson Disease Tx is a precursor to dopamine that crosses the BBB and gets processed into dopamine?

A

Levodopa (L-Dopa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the clinical use of Levodopa?

A

Parkinson’s Disease motor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the side effect of Levodopa?

A

Dyskinesias

Never given by itself

Dose may wear off early; treat with more frequent dosing or COMT inhibitor, MAO-B inhibitor, or dopamine agonist.

On/off syndrome=quick fluctuation between drug functioning and not working.

Peak dose dyskinesia=abnormal movement usually 30-90 min after dose (treat with smaller doses or adding amantadine).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the MOA of Carbidopa/Levodopa?

A

L-dopa acts as a dopamine precursor, carbidopa blocks adverse effects in the periphery & allows more L-Dopa to be available to the brain (from 1% to ~10%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the clinical use of Carbidopa/Levodopa?

A

Parkinson’s Disease motor symptoms

Most patients with Parkinson’s will take this at some point.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the side effects of Carbidopa/Levodopa?

A

Neuro: Hallucinations, confusion, psychosis, nightmares, mood changes, increased aggressiveness, involuntary movements.

CV: Orthostatic hypotension.

GI: N/V.

MSK: Dyskinesias.

Short half life; 50-90 minutes.

Highly metabolized in periphery of body (90%).

Renal excretion.

Decreased absorption if administered with a high protein meal.

Titrate (slowly increase dose).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which 2 drugs are COMT inhibitors?

A

Entacapone and Carbidopa/Levodopa/Entacppone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Entacapone’s MOA?

A

Inhibit COMT, decreasing L-DOPA degradation

Oral

NOT a monotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the clinical use of Entacapone and Carbidopa/Levodopa/Entacapone?

A

Parkinson’s Disease

Entacapon is used in conjunction with L-Dopa.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Carbidopa/Levodopa/Entacapone’s MOA?

A

Combo drug; L-Dopa+less breakdown in the periphery

Oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the side effects of Entacapone and Carbidopa/Levodopa/Entacapone?

A

Dyskinesias/dystonia, hallucinations, confusion, psychosis, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which 2 drugs are MOA-B inhibitors?

A

Rasagline and Selegiline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the MOA of Rasagline and Selegiline?

A

Inhibits Monoamine Oxidase-B, which breaks down dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the clinical use of Rasagline?

A

Parkinson’s Disease; early monotherapy if pt is still producing dopamine.

Most commonly used with L-Dopa/Carbidopa, allowing lower doses & less on/off phenomenon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the side effects of Rasagline?

A

Can make dyskinesias and hallucinations worse in high doses of L-Dopa therapy, HA, arthralgia, hallucinations, dyspepsia, depression, falls.

Higher doses can lead to MAO-A suppression and hypertensive crisis.

When taken with antidepressants and serotonergic meds=theoretical risk for serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the clinical use of Selegiline?

A

Parkinson’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the side effects of Selegiline?

A

Can make dyskinesias and hallucinations worse in high doses of L-Dopa therapy, HA, nausea, diarrhea, application site reaction (patch), insomnia, hallucinations/vivid dreams, nervousness, orthostasis, confusion.

Higher doses can lead to MAO-A suppression and hypertensive crisis.

When taken with antidepressants and serotonergic meds=theoretical risk for serotonin syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Which 3 drugs are dopamine receptor agonists?

A

Pramipexole, Ropinirole, and Rotigotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the MOA of Pramipexole, Ropinirole, and Rotigotine?

A

Dopamine agonist; stimulates dopamine receptors directly in place of dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the clinical use of Pramipexole, Ropinirole, and Rotigotine?

A

Parkinson Disease

Restless Leg syndrome = Pramipexole and Ropinirolet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the side effects of Pramipexole, Ropinirole, and Rotigotine?

A

Impulse Control Disorders, nausea, lower extremity edema, orthostasis, hallucinations, sedation, vivid dreaming, sedation.

Younger patients may do better, can be used as monotherapy

Ropinirole= Enhances impulse control disorders: “Rock and Roll Ropinirole”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which drug is a muscarinic antagonist that treats Parkinson’s Disease and drug-induced Parkinsonism?

A

Trihexyphenidyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the side effects of Trihexyphenidyl?

A

Anticholinergic/Antimuscarinic effects

(Mad as a hatter, dry as a bone, red as a beet, and blind as a bat; OR “Can’t pee, can’t see, can’t spit, can’t poop”)

Higher risk in older patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the MOA of Amantadine?

A

Unknown, likely related to effects as an NMDA receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the clinical use of Amantadine?
Parkinson's Disease, drug-induced Parkinsonism, extra-pyramidal symptoms. (H&D: Also an antiviral vs. influenza)
26
What are the side effects of Amantadine?
Insomnia, Toxic psychosis, Livedo reticularis. DO NOT USE in pts with seizures Higher risk in older patients
27
Which drug is a beta-blocker that treats essential tremors?
Propranolol
28
What are the side effects of Propranolol?
Light-headedness, fatigue, impotence, bradycardia, reduced blood pressure DO NOT GIVE to patients with severe heart failure or conduction blocks
29
Which drug is a a barbiturate that treats essential tremors?
Primidone
30
What drug treats serotonin syndrome?
Cyproheptadine
31
Which drug is a cholinesterase inhibitor that treats Alzheimer's dementia (mild to severe)?
Donepezil 
32
Which drug is a NMDA antagonist that treats moderate to severe Alzheimer's Dementia?
Memantine
33
What is the MOA of First-Generation (Typical) Antipsychotics/ Neuroleptics?
DA receptor antagonism
34
What is the clinical use of First-Generation (Typical) Antipsychotics/ Neuroleptics?
Psychotic disorders
35
What are common side effects of First-Generation (Typical) Antipsychotics/ Neuroleptics?
Dopamine Blockade SE: EPS Anticholinergic (ACh) SE: dry mouth, constipation, blurred vision, urinary retention
36
Which First-Generation (Typical) Antipsychotics/ Neuroleptic drug has low potency (ACH>EPS) and has a black box warning for patients with CVD or seizures?
Chlorpromazine (PO, Oral solution, IM)
37
Which First-Generation (Typical) Antipsychotics/ Neuroleptic drug has a high potency (EPS>ACh) and is also used to treat intractable hiccups, nausea, and vomiting?
Perphenazine (PO)
38
Which First-Generation (Typical) Antipsychotics/ Neuroleptic drug has a high potency. (EPS>ACH) and is also used to treat Tourette Syndrome?
Haloperiodol Haloperiodol Decantate (Long Acting Injection every 4 weeks) (PO, IM, IV, LAI)
39
Which First-Generation (Typical) Antipsychotics/ Neuroleptic drug has high potency (EPS
Fluphenzaine Fluphenzaine Decantate (Long acting injection every 2-6 weeks)
40
What is the MOA of Second-Generation (Atypical) Antipsychotics/Neuroleptics?
DA receptor and 5-HT antagonism/partial agonism
41
What is the clinical use of Second-Generation (Atypical) Antipsychotics/Neuroleptics?
Psychotic disorders
42
What are the side effects of Second-Generation (Atypical) Antipsychotics/Neuroleptics?
Weight gain, metabolic syndrome, type-2 diabetes Dopamine Blockade SE: EPS, hyperprolactinemia Anticholinergic SE: dry mouth, constipation, blurred vision, urinary retention All agents should include metabolic monitoring
43
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug has the highest risk of hyperprolactinemia and is FDA-approved for irritability due to Autism Spectrum Disorder (ASD)?
Risperidone (PO, ODT, Oral Solution, LAI) Risperdal Consta (LAI every 2 weeks)
44
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug is metabolized by CYP1A2, is the highest risk of weight gain, FDA-approved for schizophrenia (>13 YO)?
Olanzapine (PO, ODT, IM) Relprevv (LAI every 2-4 weeks)
45
What is the black box warning for Olanzapine and Relprevv?
Black Box Warning: do not administer within 1 hour of parenteral benzodiazepines Ralprevv Black Box Warning: Post-injection delirium sedation syndrome - REMS
46
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug has higher risk of akathisia, lower risk of weight gain and metabolic SE, and is FDA-approved for irritability due to Autism Spectrum Disorder, adjunct antidepressant, and monotherapy in bipolar disorder?
Aripiprazole (PO, LAI) Abilify Maintena (LAI every 4 weeks) Aristada (LAI every 4, 6, or 8 weeks)
47
What is the black box warning for Aripiprazole Abilify Maintena, and Aristada?
Increased risk of suicidal thoughts in patients <25 YO
48
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug is very sedating, the least deliriogenic, and is FDA-approved for bipolar disorder?
Quetiapine (PO) Seroquel (extended release)
49
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug needs to be consumed with at least 300kcal for absorption, has a higher risk of prolonged QTc, has an IM form that is very sedating, has a lower risk of weight gain, and is usually monitored with EKG?
Ziprasidone (PO, IM [Rapid])
50
What is the Route of administration of Second-Generation (Atypical) Antipsychotics/Neuroleptic drugs Paliperidone, Invega Sustenna, Ivega Trinza, and Invega Hafyera?
Paliperidone (PO, LAI) Invega Sustenna (LAI every 4 weeks) Ivega Trinza (LAI every 3 months) Ivega Hafyera (LAI every 6 months)
51
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug has a higher risk of prolonged QTc and is taken PO?
Iloperidone
52
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug needs to be consumed with at least 350kcal for absorption, has a lower risk of weight gain, and is FDA-approved for schizophrenia in adolescents and bipolar depression in patients >10 YO?
Lurasidone (PO)
53
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug is partly metabolized by CYP1A2 and is FDA- approved for acute mixed and manic episodes of bipolar 1 in adults?
Asenapine (SL) Secuado (transdermal patch)
54
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug has a lower risk of weight gain and is FDA-approved as adjunctive treatment for depression in adults and for treatment in schizophrenia patients >13 YO?
Brexpiprazole (PO)
55
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug has a lower risk of weight gain and is FDA-approved for Bipolar 1 disorder and for adjunctive MDD treatment in adults?
Cariprazine (PO)
56
Which Second-Generation (Atypical) Antipsychotics/Neuroleptic drug is metabolized by CYP1A2, can cause agranulocytosis seizures, generally used for refractory schizophrenia, and is monitored REMS (patient registry) and CBC/ANC?
Clozapine (PO)
57
When are antipsychotics useful?
Antipsychotics can be useful short-term for agitation (such as in delirium), but may take weeks for full effect in psychosis
58
What risks do antipsychotics carry?
All antipsychotics carry risk of Extrapyramidal symptoms (EPS), and therefore monitoring for abnormal movements (AIMS=abnormal involuntary movement scale) is indicated
59
All antipsychotics can theoretically increase QTc interval, but some have higher risk than others. What are they?
Aiprasidone Iloperidone
60
What kind of metabolic monitoring should occur for patients taking Second-Generation (Atypical) Antipsychotics/Neuroleptics?
BMI, fasting lipids and glucose, hemoglobin A1C
61
All Second-Generation (Atypical) Antipsychotics/Neuroleptics are metabolized by CYP3A4 except for which drugs?
Olanzapine (CYP1A2) Clozapine (CYP1A2) Asenapine (CYP1A2)
62
What is the FDA Black Box warning for all antipsychotics?
All antipsychotics confer increased risk of death in older adults with dementia-related psychosis due to cardiovascular events (heart failure, sudden death) and infections (pneumonia).
63
Compare Adverse Effects of Antipsychotic Medications.

Essentials 1.3 Drugs (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions