• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/36

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

36 Cards in this Set

  • Front
  • Back
Function of MAO-B in the brain?
Converts DA to DOPAC
Name a selective MAO-B inhibitor?
Selegiline
Possible ways that selegiline can be administered?
May be given w/ L-dopa to increase L-dopa efficacy or it can be given alone to treat very mild PD w/c will delay L-Dopa introduction.
What is the oral dosage for Selegiline?
<10mg/day to inhibit only MAO-B in the brain. If >10mg/day were given, it will also inhibit peripheral MAO-B & cause severe SE.
How effective is L dopa therapy in PD pts?
Initially in the honeymoon phase, it’s very effective but becomes less effective after 3-5yr where it starts to wear off.
What SE are seen after the honeymoon phase of L dopa & why are these signs seen?
Dyskinesia, akinesia, on & off, freezing. These SE occur b/c there is continuing loss of SN DA neurons; w/ loss L dopa can’t do its job b/c it relies on surviving DA to convert L dopa to DA
Define On-off SE of L dopa?
Unpredictable onset and offset of L dopa response
What is the freezing SE of L dopa?
Total lack of voluntary movements
What are some possible solutions of L dopa SE?
more frequent dosing, introduce COMTI, MAO-B inhibitor &/or DA agonists as combo Tx.
What are the 5 DA R agonists?
Apomorphine, bromocriptine, pramipexole, ropinirole, & rotigotine
w/c DA agonist is injection only?
Apomorphine
w/c DA agonist is a skin patch?
Rotigotine
what are the similiarities of Pramipexole & Ropinirole?
They can be used alone in early stage of PD or used w/ L-dopa in advanced PD. SE is falling asleep during daily activities.
w/c DA agonists can be given w/ L-dopa in advanced PD?
Bromocriptine, pramipexole, & ropinirole
w/c DA agonist has blood pressure irregularities?
Bromocriptine
why are DA agonists more selective for D2 than D1?
When D2 is stimulated, Gi is activated w/c decreases cAMP & therefore decreases GABA and also more D2 is found in the striatum.
What is the increasing trend or preference w/ DA agonists?
Is now given to new pts to delay L-dopa introduction so now given as monotherapy.
These drugs are useful in late stage pts after long term L dopa use?
DA agonists
This DA agonist is given to pts in the “off” state of L dopa therapy?
Apomorphine
w/c DA agonist must always be used w/ L dopa Tx?
Bromocriptine
why has rotigotine been recalled by manufacturer?
Drug crystallizes in the patch
what SE do we see w/ DA agonists?
N/V, postural hypotension.
SE of DA agonist are more severe in who? Solution to this?
Older pts suffer more from these SE so first line drugs should be L-dopa
SE of pergolide?
w/drawn from the market b/c it can cause serious damage to heart valves in a high percentage of pts
When should anti-cholinergic agents be used in PD?
Useful in pts not responding to L-dopa or agonists
Anti-chol are primary used to treat what in PD?
Tremor & rigidity
What are the 3 anti-Ach drugs?
Trihexyphenidyl, bentropine, & ethopropazine
What is the MOA in treating PD?
1)increases DA release, 2) inhibit reuptake of 5HT, 3) stimulate DA R, 4)may be anti-excitatory
When is amantadine used?
Monotherapy in early & mild PD. Can also be used in combo w/ L-dopa for pts in “wearing off”
SE of amantadine?
N, insomnia, hallucinations
The role of GDNF in PD treatment?
Since it’s essential for development, guidance, and maintenance of DA neurons, clinical trial study shows continuous delivery seems to produce benefit to early PD benefits
Relate NSAIDS & anti-oxidants to PD?
Both may be beneficial for treatment. Coenzyme Q10 possible anti-oxidant
Relate caffeine & Estrogen to PD?
Caffeine & Emay be neuroprotective; more Men have PD
What is the pathology of Huntington Dz?
There is a decrease in GABA in striatum & an increase in DA in nigra leading to excess DA activity and chorea movement
How are symptoms managed in HD?
1) Haloperidol to alleviate chorea, 2) reserpine to deplete pre-syn DA. 3) BZ used to increase GABA however their efficacy decreases as dz progresses. 4) tranquilizers to help control anxiety & 5) Li to combat pathological excitement & sever mood swings
Relate # of GLU repeats to HD development?
40 GLU repeats is the threshold for dz development; the more a pt has after 40, the early the dz will show up