Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm Unit 4 > Wk 10 > Flashcards

Wk 10 Flashcards

(96 cards)

Start Studying
1
Q

Characteristic features of Parkinson

A

Tremor
Rigidity
Bradykinesia
Postural instability

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

What occurs from complications of Parkinson?

A

death

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

Pathophysiology of Parkinson

A

Loss of dopaminergic neurons in the substantia nigra

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

50-90% of patients on levodopa for > __ years develop _____

A

5 years; motor complications

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

Two most common motor complications of levodopa

A

wearing off

on-off effect

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

wearing off effect is initially treated by ___

A

dosing more often (shorten dose interval)

later on, add dopamine agonist

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

treat on off affect:

A

w/ rescue apomorphine, or adjust dose/frequency of levodopa

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

physical disability is _____ and ___

A

progressive & unavoidable

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

initiation of therapy for Parkinson and dosing is ____

A

highly individualized

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

Mainstay of treatment since 1960s and most effective agent for PD

A

LEvodopa

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

LD ___ cross the BBB

A

does

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

significant peripheral adverse effects of Ldopa

A 
dyskinesias
N/V/anorexia
postural hypotension
mental disturbances
cardiac arrythmias
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ldopa is always administered w/ peripheral _____

A

DDC inhibitor (Carbidopa)

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

L dopa competes for absorption w/ other ___

A

amino acids

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

Ldopa has ___ minimized

A

GI upset

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

Ldopa is best absorbed w/ ___ meals

A

low protein

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

peripheral dopa decarboxylase inhibitor

A

carbidopa

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

COMT inhibitors

A

entacapone

tolcapone

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

MAO-B inhibitor

A

selegiline

rasagiline

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

carbidopa is available ___ or in ___

A

alone; combo w/ levodopa

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

____ mg CD is usually needed to inhibit peripheral DDC

A

75-100mg

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

Usually start carbidopa w/ ____ of

A

IR product of 25/100 mg (CD/LD) Simemet TID

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

Most patients respond to ____ of LD

A

750-1000mg

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

after ___ of 25/100mg, switch to 1 tab of 25/250 TID

A

8 tabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Carvidopa (brand) allows greater ___ for patients w/ advanced PD
individualized
26
COMPT is widely distributed -- ____
peripheral and central
27
entacapone is available alone as ___
generic
28
generic entacapone is <<< expensive than _____
brand tolcapone (taster)
29
levodopa/carbodopa/entacapone is called:
stalevo
30
Tolcapone is dosed as ____
single drug TID
31
tolcapone is assoc w/ _____
fatal cases of acute liver fialure
32
tolcapone has limited ____
clinical use
33
MOA of MAO-B
selective MAO-B inhibition prolongs DA effects
34
MAO-B inhibitor effects are usually ___
modest
35
MAO-B inhibitors are usually used as ____
adjunctive (add-on therapy) in advanced cases
36
when taking MAO-B inhibitors, minimize _____
tyramine intake
37
When taking MAO-B inhibitors avoid ____
cocontaminant use of SSRIs (potential for serotonin syndrome
38
early use of selegiline may _____
delay LD therapy by 9 mo
39
selegiline may improve ___
wearing off effect by 50-70%
40
MAOB-Is are less effective in improving ____
on-off effects
41
Dosing of eldepryl
BID breakfast, lunch
42
least expensive MAOB inhibitor
eldepryl
43
dosing of zelapar
daily -- decreased 1st pass effect
44
emsam is only FDA approved for ___
depression
45
MAOB-I is more poteRasagiline is more potent inhibition of MAO-B than ___
selegiline
46
brand and generic of Rasagiline are both ___
EXPENSIVE
47
Safinamide are used as ___
adjunct (add-on) therapy for Levodopa/carbidopa
48
Safinamide is useful for tx of ____
off episodes
49
adverse effects of safinamide
severe HTN (at greater than recommended doses) Hypersexual behavior Retinal degeneration
50
at what dosage of Safinamide do you see severe HTN
>100mg per day
51
DAg's cross the ___ and stimulate the ___ receptor
BBB; dopamine (d2)
52
___ improve on DAg's
ADLs
53
DAGs may be used as ___ (early) and ___ (late)
monotherapy; adjunctive
54
mono therapy w/ DAg's are more effective in ____
younger patients (<65)
55
early use of DAg's may ____
postpone use of LD
56
ergot derivatives
bromocriptine
57
removed from the market in 2007
pergolide
58
non-ergot derivatives
pramipexole ropinirole apomorphine rotigotine
59
1st gen ergot derivative that is rarely used now
bromocriptine
60
bromocriptine has increased risk of major adverse effects:
pericardial fibrosis | cardiac valve fibrosis
61
2nd generation of PD DAg
pramipexole
62
pramipexole + LD has fewer:
dyskinesias "wearing off" effects motor complications
63
dosage of IR generic pramipexole
TID
64
dosage of IR brand pramipexole
TID
65
dosage of brand pramipexole
dailyq
66
pramipexole is the only _____ DAg
really eliminated
67
the nusing pramipexole, adjust for ____
CrCl <50
68
Pramipexole has no recommended ___
taper if D/Cd
69
Ropinirole is equally efficacious per ___
indirect comparisons
70
dosage of generic ropinirole
TID
71
dosage of brand ropinrole
once daily
72
ropinirole requires a ____ if d/cd
taper over 7 days
73
ropinirole is ___ metabolized
renal dysfunctionhepatically
74
Ropinirole has no dose adjustment for ___
renal dysfunction
75
Apomorphine has a potent non-ergot ____
injectable
76
apomorphine is ___
expensive
77
FDA approved for rescue therapy of ___ or ___
hypo mobility; off episodes
78
apomorphine may cause severe ___
emesis; take w/ antiemetic
79
serotonin receptor antagonists (__) are ___ w/ apomorphine
zofran; contraindicated
80
serotonin RAs + apomorphine causes ____
severe hypotension & syncope
81
dosage of apomorphine
SC
82
contraindicated administration of apomoprhine
IV
83
only dopamine agonist transdermal patch
rotigotine
84
expensive DAg
Rotigotine
85
mainstay of treatment for PD until late 1960s
anticholinergic
86
anticholinergics are no longer ___
1st line
87
anticholinergics are reserved for ___ early in disease (<65)
resting tremor
88
side effects of anticholienrgics
constipation, dry mouth, blurred vision, confusion, urinary retention
89
benztropin may inhibit ___
reuptake of dopamine
90
usual dose of benztropin
divided BID or single dose at HS
91
dosage form for benztropin
IV/IM injection solution
92
usual dose of trihexyphenidyl
divided 3-4x/d
93
dosage form o trihexyphenidyl
oral elixer
94
amantadine is primarily an ___
antiviral agent, found to have anti-PD activity
95
amantidine was previously used as ___
early mono therapy
96
amantidine is now used as an ___
add on for levodopa -- induced dyskinesias

Pharm Unit 4 (3 decks)

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