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26 Cards in this Set
- Front
- Back
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List 4 symptoms due to parkinson's disease or loss of extrapyramidal movement control
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rigidity, bradykinesia, resting tremor, postural instability. Secondary symptoms include depression, dementia, and autonomic dysfunction
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Where is the chemoreceptor trigger zone and what does it sense?
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located outside the blood brain barrier, express dopamine receptors. It senses what is going on in the blood stream (toxins)
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True or False: Dopamine crosses the blood brain barrier
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False, it does not cross the BBB
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True or False: tyrosine does not increase dopamine levels because TH is saturated (tyrosine hydroxylase)
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True
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The name of the AAD inhibitor.
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Carbidopa
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With the use of this drug, it increases the potency of L-DOPA (which decreases the required daily dose) and (2) it decreases produciton of dopamine in peripheral tissues reducing peripheral side effects (nausea, vomiting, postural hypotension)
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Carbidopa (SINEMET)
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True or False: Excessive doses of Vit B 6, activates peripheral AAD which will possibly decrease L-DOPA levels
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True. (so too much VIT B6 with peripheral AAD will decrease L-DOPA levels.)
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What are the major side effects of L-DOPA
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Extrapyramidal dyskinesias, nausea and vomiting, psychotic symptoms: confusion, hallucination, postural hypotension: d/t activation of dopamine D1 receptors at kidney vasculature, sleep disturbances.
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Name the COMT inhibitor
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Entacapone
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This drug eventually reduces the blood level of 30 methyldopa which competes with L-DOPA for uptake in to the brain
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Entacapone (and take carbidopa to prevent LDOPA conversion to Dopamine) in the periphery
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Major side effects of Entacapone
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diarrhea, increased sensitivity to L-Dopa, hepatotoxicity
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The name brand for levodopa and carbidopa and entacapone combined
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Stalevo
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These drugs directly activate dopamine receptors in the striatum. Sometimes effective after L-DOPA loses its effectiveness (because dopamine receptors in the striatum remain intact even if nigrostriatal dopaminergic neurons are lost
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Bromocriptine. (also newer ones: pramipexole D3, ropinirole D2)
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What are the major side effects of bromocriptine
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hypotension, nausea, dyskinesias
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These Drugs have longer duration of action than L-DOPA, almost as efficacious as L-DOPA
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pramipexole, ropinirole
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What are the major side effects of pramipexole and ropinirole
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nausea and hypotension (but less than bromocriptine), confusion/hallucination, sleep disorders, risk taking behaviors (gambling), and dyskinesias (less severe than LDOPA)
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Do pramipexole and ropinirole accelerate disease progression?
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no
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What is the name of the muscarinic receptor antagonist:
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benztropine (which blocks acetylcholine from gaba receptors to decrease stimulation of the inhibitory output to cerebral cortex pg 337
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What is the side effect of Benztropine
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causs the anti-parasympathetic side effect like other muscarinic receptor blockers (dry mouth, reducing sweating, increased heart rate) ((These drugs are especially effective against tremor, but not as effective as L-DOPA)
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This drug is an antiviral agent and increases dopamine release
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Amantadine. The benefiticial effects are not as pronounced as L-DOPA. The tolerance usually occurs within weeks.
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What are MAO B blockers good for
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blocks dopamine from metabolism in the striatum
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What is the name of the MAO B blocker
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selegiline
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What does MAO-A degrade
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norepinephrine and 5-HT (seratonin)
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What does MAO-B degrade
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it metabolizes dopamine (this drug is for parkinsons)
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True or FAlse: Selegiline is only weakly effective against symptoms, but neuroprotection claimed (not generally accepted at present)
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True
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Drug interactions of MAO-B Blockers.(2) These drugs are contraindicated with meperidine or tricyclic antidepressants because of ___________ syndrome. These drugs use with L-DOPA is complicated because of _______ ________
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SEROTONIN syndrome (hyperthermia).
Portal hypertension (due to the conversion of excessive dopamine to norepinephrine. |
