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30 Cards in this Set

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  • Back
Levodopa (L-Dopa, Larodopa)
Parkinson's-DP enhancer
DP intermediate, "precursor loading"
initially relieves all Sx except dementia, 3-4 years
SE: N/V, ortho hypotension, arrhythmia, diskinesias
Contra: schizophrenia, dysrhythmia and CAD
Carbidopa (w/ L-dopa in Sinemet)
Parkinson's-DP enhancer
MOA: inhibits peripheral decarboxylation of levodopa, increasing amount in brain
decreases effective dose, diminishes N/V, CV side effects
Bromocriptine (Parlodel)
Parkinson's-DP enhancer
MOA: dopamine agonist acting at dopamine2 (D2) receptors but antagonist at D1 receptors
not first line, used refractory to levodopa
SE: like L-dopa, 1st dose effect-hypotension, hallucinations, vasospasm
ropinirole (Requip)
pramipexole (Mirapex)
Parkinson's-DP agonist
can be used w/ or w/o L-dopa
Pramipexole anti-depressant
Rotigotine (Neurpo)
Parkinson's-DP agonist
brand new transdermal patch formulation a non-ergot dopamine agonist
apomorphine (Apokyn)
Parkinson's-DP agonist
used to treat freezing episodes
amantadine (Symmetrel)
Parkinson's-DP agonist
MOA: inc. release of DP
less effective than L-dopa
SE: depression, insomnia, agitation, spider veins
CI: seizures or CHF
selegiline (deprenyl, Eldepryl)
Parkinson's: DP breakdown inhibitor
MAO: selective MAO-B inhibitor
inc. efficacy of L-dopa use
prevents rigid addict from happening
rasagiline (Azilect)
Parkinson's: DP breakdown inhibitor
MOA: newer MAO-B selective inhibitor
Tolcapone (Tasmar)
Parkinson's: DP breakdown inhibitor
MOA: reversible inhibitor of catechol-O-methyl-transferase (COMT)
adjunct for L-dopa at end of treatment
SE: have to monitor liver, cant have movement abnormalities
Entacapone (Comtan)
Parkinson's: DP breakdown inhibitor
MOA: reversible inhibitor of catechol-O-methyl-transferase (COMT)
adjunct L-dopa
longer, better than Tolcapone
benztropine (Cogentin)
Parkinson's: anticholinergic agents
MOA: antimuscarinic
can be used w/ or w/o L-dopa
SE: confusion, mood changes, blurred vision, tachy, mydriases, constipation
trihexyphenidyl (Artane)
Parkinson's: anticholinergic agents
MOA: antimuscarinic
can be used w/ or w/o L-dopa
SE: confusion, mood changes, blurred vision, tachy, mydriases, constipation
selegiline (Deprenyl)
Parkinson's: neuroprotective agent
MOA: inhibits monamine oxidase type B (MAO-B)
treatment early in the course of PD delays the onset of more severe symptoms
Tx of huntingtons (symptomatic only)
Fluoxetine (Prozac)-treat depression and irritability
Clozapine (Clozaril)-Rx of psychosis, paranoia & other delusional states
Reserpine-Used for large amplitude chorea
tetrabenazine (Xenazine)
Huntingtons
mech of ax: reversible depletor of monoamines (dopamine, 5-HT, norepineprhine) in the brain
Tacrine (Cognex)
Alzheimers: Acetylcholinesterase Inh.
MOA: Centrally-acting AChE inhibitor
absorbed rapidly, peak 1-2
SE: Hepatotoxicity Cholinomimetic effects
Donepezil (Aricept)
Alzheimers: Acetylcholinesterase Inh.
MOA: Centrally acting AChE inhibitor
100% bioavail., peak 3-4 hours
SE: Cholinomimetic effects-
nausea, vomiting, diarrhea, muscle cramps and fatigue
Rivastigmine (EXELON)
Alzheimers: Acetylcholinesterase Inh.
MOA: 2X daily central AChE inhibitor which is devoid of liver metabolism
Cognitive improvement
Galantamine (REMINYL)
Alzheimers: Acetylcholinesterase Inh.
MOA: Central AChE inhibitor AND nicotinic agonist
Memantine (NAMENDA)
Alzheimers: Acetylcholinesterase Inh.
MOA: NMDA (glutamate) antagonist
Prevents excitotoxicity due to excess glutamate
Interferon beta-1b
MS
halt and even reverse the progression of MS
MOA: increasing the cytotoxicity of NK cells; increasing phagocytic activity of macrophages
reduces interferon-gamma secreted by lymphocytes
Interferon beta -1a
MS
same as interferon beta 1b
Natalizumab
MS
MOA: blocks cell adhesion pathway and inhibits lymphocytes entry into the CNS (can cause pathology of MS)
Glatiramer acetate
MS
MOA: mimics myelin basic protein, a component of the myelin covering nerve fibers
acts as a decoy to T cells that damage myelin
Mitoxantrone
MS
MOA: suppresses activity of T cells, B cells, and macrophages that attack the myelin sheath
adrenal corticosteroid drugs
MS
MOA: anti-inflammatory activity; corticosteroids shorten the duration of relapse and lessen symptoms
antispastic drugs
MS
MOA: inhibit spinal reflexes
Riluzol (Rilutek)
ALS
MOA: Inhibits glutamate release
Blocks glutamate receptors
Inhibits Na+ channels
and undefined GPCR interaction
SE: elevation of Hep. enzymes, N/V MINOR
Baclofen (Lioresal)
ALS
MOA: GABA-B agonist
Increases the extensor tone and clonus
used to treat spasticity of the muscles