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36 Cards in this Set
- Front
- Back
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What is main NT assoicated with Alzheimer's Disease
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Ach (associated with memory and learning)
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What is the major NT associated with Parkison's Disease
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Dopamine
(emotions, and musculoskeletal movement) |
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The mean of Parkinson's Disease for onset is
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60 years
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What is cause of Parkinson's Disease
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idopathic, heavy metal intoxication, desruction of dopaminergic neurons
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What drugs can cause Parkinson's Like symptoms
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Antipsychotics, metoclopramide, valproic acid, CCB
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Parkinson's Disease, dopamine is depleted, what happens are as result--
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NO inhibition of ACH, so increase ACH levels causing the tremor
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So ultimately PD is an imbalance between DA and Ach (less DA and TONS of Ach)
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YES
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What are the most common symptoms with PD
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muscle ridight, tremor, and instability (postural instability)
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What is the GOLD standard for treatment of PD
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Levodopa/Carbidopa
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What are other options beside Levodopa/Carbidopa
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Dopamine Agonits (Pramipexol, Ronpinirole, COMT inhibitors, MOA I, Anticholineric agents(controling tremors)
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DOPAMINE Is never given becuase it CANNOT cross BBB,
Why is L-DOPA never given by itself |
broken down by L-amino acid decarboxylase to Dopamine in the periphery and limited amount Dopamine gets to brain, and LOTS of SE (N/V)
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What is role of Carbidopa/Levodopa
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Carbbidopa inhibits the PHERIPHERAL converison of L-amino acid decarboxylase inhibtor, and increases L-DOPA delivery to the brain
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What are SE of Carbidopa/L-Dopa (Sinemet)
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Hallucinations (increased DA), Nightmares, Deliturm, Confusion)
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Anything that INCREASES dopamine can cause
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hallucinations
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What are the Dopamine Agoinsts
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Pramiprexole (Mirapex) Ropinirole (Mirapex), Bromocriptine
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Pramiprexole, and Ropinirole stimulate what dopamine receptors
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D2,D3 receptor AGOINST
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What is dosing of Dopmaine agoinsts compared to restless leg syndrome
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RLS--qhs, verus PD TID
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Should you abruptly stop DA
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NO should always taper
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What the COMT inhibitors (
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(Entacapone, Tolcapone)
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What is the MOA of COMT inhibitors
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inhibit the peripheral conversion of L-DOPA to Dopamine, by inhibiting COMT (increase DA delivery to the brain
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The COMT inhibitors are NOT used often and only as adjustive thearpy, why is Tolcapone not use
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causes LIVER failure
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What are the MOA inhibitors
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Selegiline, and Rasagiline
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What is the NORMAL role of MOA inhbitors
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break down CCA, and 5HT
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What the MAJOR DI with MAO-I
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SSRIs, TCA, Tramadol, meperidine
ANYTHING that increases 5HT,and NE |
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What are the anti-cholinergic agents used for PD (and antipyschotics)
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Trihexyphenidyl, and benztropine
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What are the anticholinergics effective for
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TREMOR
little effect on bradykinesia |
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What is NT responsible for Alzihmer's disease
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loss of Ach
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What are the MAIN drug treatments for AD
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Cholinesterase Inhibitors
NMDA antagoints |
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The Cholinesterease inhibitors are 1st line agents for treamtent of AD, what are the 3 main
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Donepezil, Rivastigmine, Galantamine
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What are benefits of Chohlinesterease inhbitors
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decrease MMSE (2-4 pts), improvoent in cognitive scores
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What is MOA of Cholinesterase Inhibitors
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inhibit the degreadtion of Ach, and increase levels
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What is the only Cholinesterase Inhibitor for ALL 3 indications
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Donepezil
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What are the formulations of Rivastigmine
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Patch, Tablet
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What are the SE's of Cholinesterase Inhibitors
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N/V diarrhea
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What are the NMDA antagoinsts
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Memantine
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What is role of Memantine
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moderate to severe AD (adjuntive is MAIN role)
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