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