(Neuro) Parkinson's And Antispasmatic Drugs

Front 1

Drug Name: Benztropine
Where applicable list:

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Back 1

USES: Parkinson's (especially useful to alleviate excessive salivation)
MECHANISM: Anticholinergic. Less effect on periphery than atropine
SIDE EFFECTS: Similar to atropine
TOXICITY:
ANTIDOTES:
CONTRAINDICATIONS: Narrow angle glaucoma; prostatic hypertrophy
INTERACTIONS:
OTHER: Good for mild cases, or when treatment when L-Dopa is contraindicated (drug tx schizophrenia) / not tolerated

Front 2

Drug Name: Trihexaphenidyl
Where applicable list:

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Back 2

USES: Parkinson's (especially useful to alleviate excessive salivation)
MECHANISM: Anticholinergic. Less effect on periphery than atropine
SIDE EFFECTS: Similar to atropine
TOXICITY:
ANTIDOTES:
CONTRAINDICATIONS: Narrow angle glaucoma; prostatic hypertrophy
INTERACTIONS:
OTHER: Good for mild cases, or when treatment when L-Dopa is contraindicated (drug tx schizophrenia) / not tolerated

Front 3

Drug Name: L-Dopa
Where applicable list:

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Back 3

USES: Parkinson's
MECHANISM: Crosses BBB; gets converted by enz AADC to dopamine
SIDE EFFECTS: Abnormal movements (most severe SE); hypotension; vomiting (D2 acts on CTZ)
TOXICITY:
ANTIDOTES:
CONTRAINDICATIONS: Narrow angle glaucoma; peptic ulcers; melanoma; pulmonary disorders, CV disease; recent MI w/ arrhythmia
INTERACTIONS: Vitamin B6 (w/out carbidopa); Antipsychotics (decrease level of dopamine); Combination with non-specific MAOi can lead to hypertensive crisis.
Interactions with anticholinergics can be therapeutic
OTHER: Often combined with carbidopa to prevent conversion of L-dopa to dopamine in periphery

Front 4

Drug Name: Carbidopa
Where applicable list:

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Back 4

USES: Parkinson's; Enhancer of l-dopa
MECHANISM: Inhibits peripheral (but not central) conversion of l-dopa to dopamine by AADC. (Dopamine cannot cross BBB)
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OTHER: Drug has very little effect when taken alone.

Front 5

Drug Name: Amantadine (Symmetril)
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Back 5

USES: Parkinson's; A2 influenza
MECHANISM: Increases dopamine possibly by weakly blocking NMDA glutamate receptors. Efficacy between anticholinergics & l-dopa.
SIDE EFFECTS: Similar to, but less severe than l-DOPA.
TOXICITY:
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OTHER: Often used late in treatment as an add-on

Front 6

Drug Name: Brimocriptine (Parlodel)
Where applicable list:

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Back 6

USES: Parkinson's; Amenorrhea
MECHANISM: D-2 agonist.
SIDE EFFECTS: Vomiting
TOXICITY:
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OTHER: Expensive; often used as an add-on therapy; increases 'on-time'

Front 7

Drug Name: Ropinirole
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Back 7

USES: Parkinson's; Restless leg syndrome
MECHANISM: Dopamine agonist. Binds stronger to D3 rather than D1/D2.
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OTHER: Relatively new drug; Often used in younger people

Front 8

Drug Name: Cabergoline
Where applicable list:

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Back 8

USES: Parkinson's
MECHANISM: Dopamine agonist. Somewhat D2 selective
SIDE EFFECTS: May cause more dyskinesias than other dopamine agonists
TOXICITY:
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OTHER: Relatively new drug

Front 9

Drug Name: Pramipexole
Where applicable list:

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Back 9

USES: Parkinson's
MECHANISM: Dopamine agonist. Binds to D3 and D4 rather than D2. Also an alpha-2 agonist
SIDE EFFECTS: Sedation (alpha-2 agonism)
TOXICITY:
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OTHER: Relatively new drug; Often used in younger people

Front 10

Drug Name: Selegiline (Eldapryl)
Where applicable list:

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Back 10

USES: Parkinson's
MECHANISM: MAO-B inhibitor; potentates l-dopa and stabilizes dopamine levels; converted to amphetamine
SIDE EFFECTS: Minimal
TOXICITY:
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INTERACTIONS: Important interactions: meperidine, some antidepressants
OTHER:

Front 11

Drug Name: Rasagliline
Where applicable list:

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Back 11

USES: Parkinson's
MECHANISM: MAO-B inhibitor (irreversible); produces greater stability in dopamine levels than selegiline
SIDE EFFECTS: Minimal
TOXICITY:
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INTERACTIONS: Same as selegiline? (meperidine / some antidepressants)
OTHER: Increasingly used in early treatment of disease

Front 12

Drug Name: Tolcapone (Tasmar)
Where applicable list:

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Back 12

USES: Parkinson's
MECHANISM: COMT inhibitor; stabilizes dopamine levels.
SIDE EFFECTS: Similar to l-dopa SE; nausea, anorexia, diarrhea, hallucinations (rarely)
TOXICITY: According to Jen's notes fatal liver toxicity (Entacapone is in same class but does not affect liver)
ANTIDOTES:
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OTHER:

Front 13

Drug Name: Diphenhydramine
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Back 13

USES: Antihistamine; Parkinson's
MECHANISM: Decreases amount of acetylcholine.
SIDE EFFECTS: Similar to other anticholinergics (sedation, urinary retention, etc)
TOXICITY:
ANTIDOTES:
CONTRAINDICATIONS: Narrow angle glaucoma, prostatic hypertrophy
INTERACTIONS:
OTHER: Available in parenteral administration (useful for extrapyramidal motor rxns)

Front 14

Drug Name: Cyclobenzaprine & Metaxalone
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Back 14

USES: Antispasmatic (sedating drug)
MECHANISM:
SIDE EFFECTS: Anticholinergic side effects
TOXICITY:
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OTHER: Sprains and strains

Front 15

Drug Name: Benzodiazepine
Where applicable list:

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Back 15

USES: Sedating drug
MECHANISM: GABA-A agonist; used in higher doses than for anti-anxiety
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OTHER: Sprains and strains

Front 16

Drug Name: Baclofen
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Back 16

USES: ALS, MS, Spinal cord injury, some movement disorders
MECHANISM: GABA-B agonist; increases potassium influx at nerve terminals thus reducing Calcium intake following action potential
SIDE EFFECTS: Sedation; weakness; confusion; withdrawal (anxiety/hallucinations)
TOXICITY: Dangerous overdose
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OTHER:

Front 17

Drug Name: Tizanidine
Where applicable list:

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Back 17

USES: MS; spinal cord damage; stroke
MECHANISM: Alpha-2 agonist; acts on boutons synapsing on motor neurons
SIDE EFFECTS: Sedation; dry mouth; dizziness
TOXICITY:
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OTHER:

Front 18

Drug Name: Dantrolene
Where applicable list:

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Back 18

USES: Antispasmatic; malignant hyperthermia; neuroplastic malignant syndrome
MECHANISM: Acts directly on muscles; causes a decrease in release of calcium from sarcoplasmic reticulum
SIDE EFFECTS: Muscle weakness, dizziness, fatigue
TOXICITY: Liver toxicity
ANTIDOTES:
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OTHER: