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15 Cards in this Set

  • Front
  • Back
Pathology of Parkinsons
- loss of dopamine containing neurons with cell bodies in the substantia nigra projecting to the striatum
- 80% lost to observe symptoms
Dopaminergic function is restored by giving...
- L-dopa
what is given with L-dopa to enhance it's effect
- carbidopa
Do not give what with L-dopa?
- pyridoxine
How do pts respond to L-dopa?
- 2/3 respond, but relief is temporary
- On-Off phenomenon
What are the major side effects of L-dopa?
- extrapyramidal abnormalities
- nausea
- psychotic symptoms at high doses: sleeping disorders, nightmares
Direct acting dopamine agonists (3)
- Bromocriptine
- Ropinirole
- Pramipexole
Bromocriptine (D1/D2 agonist)
what are side effects
- hypotension and pronounce nausea
Ropinirole (D2 agonist) and pramipexole (D3 agonist)
What are side effects
- fatigue, sleep disorders (vivid dreams)
- nausea
- edema
- dyskinesias (but less severe as those with bromocriptine)
When can Direct acting dopamine agonists be used?
- often after L-Dopa loses its effectiveness
Name the muscarinic antagonist in this class of drugs (decreased cholinergic function)
- benztropine
Mechanism of benztropine
- parkinson's can cause too much Ach to be released
- that is how a muscarinic antagonist can be effective
Side effects of Benztropine
- dry mouth, reduced sweating, increased heart rate
- can also effect memory
- antiviral agent
- increases dopamine release
- mechanism unknown
- tolerance often occurs
- convulsions at high doses
- not as effective as L-Dopa
- MAO-B blocker
- prevents the metabolism of dopamine!!!
- often added to other drugs