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17 Cards in this Set

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l-DOPA
Mechanism: partial replacement for Parkinson's forebrain dopamine deficiency

Clinical Use: Parkinson's

Side Effects: fluctuating response and movement disorder after 2 yrs of use due to pharmacodynamic changes, visual hallucinations and paranoid psychosis
Carbidopa
Mechanism: Inhibits DOPA decarboxyolase in periphery -> reduced peripheral side effects of L-DOPA

Clinical Use: Parkinson's
COMT inhibitors
-Tolcapone
-Entacapone
Mechanism: COMT inhibitors -> increased L-DOPA availability

Clinical Use: Parkinson's

Side Effects: increased l-DOPA actions (dyskinesia, psychosis), fatal hepatic necrosis
Bromocriptine
Pergolide
Mechanism: D2 agonist and bromocriptine is partial D1 antagonism and pergolide is weak D1 agonist

Clinical Use: Parkinson's

Side Effects: nausea, hypotension, somnolence, hallucination
pergolide -> cardiac valve thickening
Pramipexole
Ropinirole
Mechanism: highly selectie for D2 family (D2, D3, D4)

Clinical Use: early Parkinson's, late combined with l-DOPA/carbidopa

Side effects: same as non-selective agonists
Amantadine
Mechanism: increases DA release

Clinical Use: early Parkinson's esp. tremor, suppresses drug induced dyskinesia

Side Effects: well tolerated, confusion in elderly
Benztropine
Trihexiphenydil
Mechanism: Anticholinergics

Clinical Use: early Parkinson's symptoms esp. tremor

Side Effects: typical anticholinergic signs (mydriasis, constipation, dry mouth, memory loss, confusion)
Selegiline
Mechanism: selective MAO-B inhibitor

Clinical Use: used with l-DOPA in Parkinson's if declining or irregular respons to l-DOPA; slows the rate of clinical progression in early Parkinson's
Baclofen
Mechanism: GABA-B agonist

Clinical Use: spasticity
Benzodiazepines
Mechanism: GABA-A agonist

Clinical Use: spasticity, tremor
Tizanidine
Mechanism: alpha antagonist

Clinical Use: spasticity
Classical and Atypical Neuroleptics
-Chlorpromazine
-Clozapine
Mechanism: block D2 family

Clinical Use: hyperkinetic-rigid symptoms, tics

Side Effects: Tardive Dyskinesia (not with clozapine which can actually depress movements with TD)
5-hydroxytryptophan
Mechanism: precursor of serotonin

Clinical Use: ataxia, myoclonus (w/ carbidopa)
Primidone (Mysoline)
Tremor
Propranolol
non-selective beta antagonist
low doses for essential tremor
Botox
Mechanism: inhibits ACh release

Clinical Use: Dystonia, spasticity
Penicillamine
Copper chelating agent for Wilson's disease movement disorders