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24 Cards in this Set
- Front
- Back
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levodopa
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- crosses BBB
- decarboxylation can happen all over the body |
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carbidopa
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- decarboxylase inhibitor
- given w/levodopa to increase efficacy |
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sinemet
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- levodopa + carbidopa
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tolerable dose decreases w/time
efficacy decreases with time treats symptoms, not progression |
- disadvantages of levodopa
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bradykinesia
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- levodopa is most effective in treating this symptom
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dopamine agonists
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- used to tx parkinson's
- synthetic and therefore not subject to decarboxylation |
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bromocriptine, pergolide, pramipexole, ropinirole
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- the dopamine agonists
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bromocriptine
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- 1st line dopamine agonist
- a partial agonist |
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pergolide
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- 2nd line dopamine agonist
- decreases L-dopa fluctuation |
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monoamine oxidase inhibitors
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- use in early-mid stage parkinsons
- decrease breakdown of dopamine in cleft - increase dopamine cycling |
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selegiline
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- a MAOI
- selective MAO-B inhibitor - decreases dopamine breakdown - adjunctive tx to L-dopa |
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MAO-B
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- metabolizes dopamine
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MAO-A
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- metabolizes serotonin/NE
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if patient is taking trycyclic antidepressants, SSRIs
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- CI for selegiline
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tolcapone
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- inhibits COMT
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amantadine
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- an anti-viral used to tx parkinson's
- may influence dopamine release/reuptake/synthesis - short-term benefits |
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rigidity, tremor, bradykinesia
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- symptoms improved by amantadine
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anticholinergics
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- used to tx parkinsons
- decrease Ach for better balance - all are derivatives of atropine |
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benztropine, biperiden, orphenadrine, procyclidine
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- anticholinergics used in tx parkinson's
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benztropine (cogentin)
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- an anticholinergic used to tx parkinsons
- if taken orally --> total cycloplegia |
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rigidity, tremor
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- parkinson's symptoms improved by anticholinergics
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anticholinergics
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- mix well w/L-dopa to tx parkinson's
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prostatic hyperplasia, obstructuve GI disease
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- CIs for anticholinergics
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tardive dyskinesia
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- result of long-term anti-psychotic use
- looks like parkinsons, but its not |
