Neuro 4: Antiparkinson Drugs

Front 1

What drugs may cause Parksonian symptoms?

Back 1

Drugs which deplete dopamine (Reserpine) or block receptors (antipsychotics: chlorpromaine, haloperidol)

Front 2

What type of drug is Pramipexole?

Back 2

D2 agonist

Front 3

What type of drug is Ropinirole?

Back 3

D2 agonist

Front 4

What type of drug is Bromocriptine?

Back 4

D2 agonist

Front 5

What type of drug would you use for drug-induced extrapyramidal effects?

Back 5

Anticholinergic agents

Front 6

What is the rate limiting step in dopamine synthesis?

Back 6

Tyrosine Hydroxylase (Tyrosine-->DOPA) That is why we give DOPA (to skip the bottleneck)`

Front 7

Why don't we give Dopamine?

Back 7

Cannot cross the BBB

Front 8

What is a GI side effect of Levodopa?

Back 8

GI (Nausea and vomiting) due to stimluation of chemoreceptor Trigger zone

Front 9

Patients with what may be a contraindication to Levodopa?

Back 9

Heart problems (NE and Epi synthesized from dopamine in some neurons)

Front 10

wWhat side effect of Levodopa occurs in about 15% of patients?

Back 10

Psychiatric/behavioral problems

Front 11

What is the point of administering Carbidopa with Levodopa?

Back 11

It prevents periphera conversion of l-dopa to dopamine and allows for lower doses of Levodopa

Front 12

What are some advantages to using Carbidopa?

Back 12

Can reduce the effective dose of Levodopa, reduced GI symptoms, more control

Front 13

What are some disadvantages to using Carbidopa?

Back 13

Orthostatic Hyoptension not helped, involuntary movements may occur earlier, be more severe, and last longer

Front 14

What precautions do you need to use when using Carbidopa and Levodopa?

Back 14

Psychiatric patients, pts with asthma or emphsyma using other adrenergic agents, and pts on MAO-A inhibitors

Front 15

a useful adjunct especially in patients with an "end of dose" fluctuating response to treatment

Back 15

Entacapone

Front 16

What type of drug is Entacapone?

Back 16

COMT inhibitor

Front 17

What enzyme does Carbidopa inhibit?

Back 17

DOPA decarboxylase (L-DOPA to Dopamine)

Front 18

What drugs have also been proven to treat restless leg syndrome?

Back 18

Pramipexole and Ropinirole

Front 19

What are some advantages to using Pramipexole and Ropinirole?

Back 19

Less likely to induce dyskinesias and longer duration of action

Front 20

What type of drug is Amatidine?

Back 20

Antiviral agent (NMDA antagonist)

Front 21

What type of drug is Selegiline?

Back 21

MAO-B inhibitor (preserves dopamine in the basal ganglia)

Front 22

What is a side effect of Selegiline?

Back 22

Insomnia probably due to an amphetamine like metabolite

Front 23

What is Selegiline metabolized to?

Back 23

Amphetamine derivative that may be neurotoxic

Front 24

What type of drug is Trihexyphenidyl?

Back 24

Anticholinergic agent

Front 25

What type of drug is Benztropine?

Back 25

Anticholinergic agent

Front 26

What two drugs are the only approach to drug-induced Parkinson effects?

Back 26

Trihexyphenidyl and Benztropine (can't work on the dopamine side, thus work on the cholinergic side)

Front 27

What are some side effects of anticholinergic agents (Trihexyphenidyl and Benztropine)?

Back 27

Heat stroke (no sweating), urinary retention, failure to accommodate