Parkinsons Drugs

Front 1

Levodopa
converted to dopamine in the brain and peripheral tissues(undesirable as causes n/v, hypotension), replenishing depleted striatal dopamine
carbidopa/benserazide = dopa decarboxylase inhibitors
entacapone = COMT inhibitor (more levodopa for the brain) and dec. peripheral adverse effects

Back 1

D: 300-800mg d in 3 or more doses
I: PK
SE: n/v
orthostatic hypotension,
dyskinesia
psych sx (depression, hallucinations, agitation, confusion)
anorexia
insomnia
mydriasis (dilation of pupil)

Hint 1

C: 1, 9, 16
! take this medication at the same time each day and in the same way (e.g. always before food)
! may cause discolouration of urine (red) and faeces (black)
! do not crush, chew or halve CR preps (A)
MONITOR:
LFT (entacapone)
GI bleeding
HR, BP

Front 2

Dopamine Agonists

Back 2

I: Parkinson’s disease
Acromegaly (where surgery/radiotherapy ineffective or C.I.)
Hyperprolactinaemia, including prolactinomas

SE: n/v (act on DA receptors in
CTZ)
GI upset
orthostatic hypotension,
dizzy
psych sx (hallucinations, confusion, delusions, psychotic episodes),
dyskinesia
fatigue
impulse control disorders

Hint 2

12, 16, B
! with or soon after food (reduce chance of nausea and stomach upset)
! start at night
start low, go slow

Front 3

Bromocriptine

Back 3

PD: 10-40mg d (divd doses)
hyperprolactinaemia: 1.25mg bd, tds
Lactation: 2.5mg BD for 14d

Hint 3

MONITOR:
prolactin levels
visual field (pituitary enlargment)
BP
behaviour
progressive fibrotic disorders

Front 4

Cabergoline

Back 4

PD: 3mg d
HP: max 2mg/week
Lactation: 1mg as a single dose first day post partum

Hint 4

MONITOR:
prolactin levels
visual field (pituitary enlargment)
BP
behaviour
progressive fibrotic disorders

Front 5

Pergolide

Back 5

PD: 3mg in 3 divid doses (M 5mg d)

Hint 5

MONITOR:
manufacturer recommends regular CV evaluation ECG @ 0, 3-6, then every 6-12months

Front 6

Amantadine
Increases dopamine release and blocks cholinergic receptors; glutamate antagonist

Back 6

D: 100mg d (bd < 65yo)
I: Parkinson’s disease
Prevention of influenza type A in non-immunised people (100 mg bd for 10 days)
SE: dry mouth, blurred vision,
constipation, urinary
retention, orthostatic
hypotension, dizziness,
depression, nightmares,
hallucinations

Hint 6

9, 12, 16, B (red. stomach upset)
MONITOR:
Vision

Front 7

Anticholinergics
blocks muscarinic actions of Ach thus DEC. the relative excess of
cholinergic activity that accompanies dopamine deficiency
in PD

Back 7

I: PD
Drug-induced EPS (except tardive dyskinesia) [1-4mg od or bd]
SE: rash, dry mouth/eyes, blurred vision, constipation, urinary retention, arrhythmia, dizziness, drowsiness, headache

Hint 7

1, 9, 16
MONITOR:
IOP

Front 8

Benztropine

Back 8

D: 6mg d