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24 Cards in this Set
- Front
- Back
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what is parkinsons
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when 80% of dopamine producing cells die-causing rigidity
starts out unliaterly and progresses to bi-laterally |
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drugs that can cause psuedoparkinsonism
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phenoziathiazines
haloperidol paliperidone (less) risperidone at high doses metoclopramide |
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carbidopa/levodopa
brand name? MOA forms it comes in |
Sinemet, sinemet CR
levodopa- precursor for DA, carbidopa inhibits dopa decarboxylase from metabolizing levodopa IR and SR, SR can be cut in half but not crushed |
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how much czrbidopa is needed to decrease Nausea and be effective
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70-100mg
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SE of sinemet
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black/brown urine
N/DIZZINESS Sexual urges separate dosing from protein intake |
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what is parcopa
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"Rapi tab"- levo/carbidopa as SL form
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COMT inhibitors
MOA meds |
inhibits the enzyme, COMT, to prevent breakdown of levodopa
-us only with levodopa entacapone |
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entacapone
brand name? SE |
comtan
SE- like levodopa, urine color changes, nausea |
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stavelo
gen name |
levodopa/ carbidopa + entacapone
give 200mg w each dose |
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DA agonist meds
SE |
pramipexole
ropinrole rotigotine SE- drowsiness, sudden daytime sleep attacks, hallucinations |
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pramipexole
brand name? also approved for |
Mirapex, Mirapex ER
RLS |
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DA agonists metabolized how
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renal
dec pramipexole if crcl <60 |
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ropinrole
brand name |
requip, requip XL
used in RLS also |
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rotigotine
Brand |
neupro
comes as a patch |
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med used for advanced disease, a rescue movement agent for OFF periods
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apomorphine (apokyn)
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apomorphine
given how CI with? SE |
SC
give in addition to other PD meds, only last an hour CI- with 5HT antagonists SE- severe nausea, vomitting |
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start what med before apomorphine to limit nausea
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tigan (trimethobenzamide
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additional meds
amantadine brand name? MOA? |
symmetrel
dopamine reuptake inhibitor- for mild PD or advanced dyskinesias |
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SE with amandatine requiring D/C
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livedo reticularis- reddish skin rash
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selective MAO-B inhibitors
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selegiline
rasagiline |
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selegiline
comes as... place in tx |
eldepryl 5 to 10 mg daily
zelpar- ODT 1.25-5mg daily emsam- patch used as adjunctive-benefit only with levodopa |
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rasagiline
brand name place in tx |
azilect
can be used as initial tx or ADJUNCTIVE with levodopa |
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centrally acting anticholinergics for PD
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used in YOUNGER PT's, not elderly
benztropine trihexphenidyl |
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ropinrole and pramipexole should be titrated how
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increase weekly
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