Pharm Tb3 Parkinson/alzheimer Drugs

Front 1

What is amantadine?

Back 1

An anti-viral agent that alters release and uptake of dopamine in the CNS, used to treat Parkinson's

Front 2

What is benztropine?

Back 2

A selective CNS muscarinic receptor antagonist used to treat Parkinson's

Front 3

What is biperiden?

Back 3

A selective CNS muscarinic receptor antagonist used to treat Parkinson's

Front 4

What is bromocriptine?

Back 4

Non-selective dopamine agonist used to treat Parkinson's

Front 5

What is carbidopa?

Back 5

Peripheral DOPA decarboxylase inhibitor used to treat Parkinson's

Front 6

What is entacapone?

Back 6

Catechol-O-Methyltransferase inhibitor that works only in the periphery, Anti-Parkinson's drug

Front 7

What is levodopa?

Back 7

Anti-Parkinson's drug

Front 8

What is pergolide?

Back 8

Non-selective dopamine agonist used to treat Parkinson's

Front 9

What is pramipexole?

Back 9

selective D2 dopamine agonist used to treat Parkinson's

Front 10

What is ropinirol?

Back 10

selective D2 dopamine agonist used to treat Parkinson's

Front 11

What is selegiline?

Back 11

A selective MAO-B inhibitor used to treat Parkinson's

Front 12

What is trihexyphenidyl?

Back 12

A selective CNS muscarinic receptor antagonist used to treat Parkinson's

Front 13

What is tocapone?

Back 13

Catechol-O-Methyltransferase inhibitor that works in the periphery AND CNS; used to treat Parkinson's

Front 14

What is tacrine?

Back 14

Cholinesterase inhibitor and weak antangonist of muscarinic and nicotinic receptors, used to treat Alzheimer's

Front 15

What is donepezil?

Back 15

CNS anticholinesterase used to treat Alzheimer's

Front 16

What is rivastigmine?

Back 16

Anti-Alzheimer's drug - cholinesterase inhibitors

Front 17

What is glantamine?

Back 17

Anti-Alzheimer's drug - cholinesterase inhibitors

Front 18

What is Riluzole?

Back 18

Anti-ALS drug: presynaptic and postsynaptic glutamate release inhibitor and blocks postsynaptic glutamate receptors and inhibits sodium channels

Front 19

What is the actionof levodopa?

Back 19

increases dopamine production within the basal ganglia - it is the immediate precursor of dopamine

Front 20

How is levodopa absorbed?

Back 20

in the small intestine by an active transport system for aromatic amino acids

Front 21

What is levodopa always given with?

Back 21

cabidopa - allows for smaller doses of levodopa to be effective

Front 22

What is the action of carbidopa?

Back 22

it is a peripheral DOPA decarboxylase inhibitor

Front 23

What is the 'wearing off effect'?

Back 23

fluctuation in clinical response: progressive shortening of duration of benefit of levodopa with each dose

Front 24

What is the 'on-off' effect?

Back 24

unpredictable fluctuations between periods of immobiltiy and improved mobility seen with levodopa

Front 25

Which patients should NOT receive levodopa?

Back 25

psychotic patients - it will exacerbate mental disturbances

Front 26

What are the adverse side effects of levodopa?

Back 26

nausea, vomiting, orthostatic hypotension, cardiac arrhythmias, HTN, dyskinesia, mydriasis, glaucoma, behavioral effects - depression, anxeity, insomnia, confusion, delusions etc.

Front 27

What enhances extracerebral metabolism of levodopa?

Back 27

vitamin B6 (pyridoxine)

Front 28

What are advantages of dopamine agonists compared to levodopa?

Back 28

show less response fluctuation and have a longer duration; not dependent on capable cells for uptake and metabolism

Front 29

What is the role of MAO B with dopamine?

Back 29

acts as an important enzyme in the CNS metabolism of dopamine

Front 30

What does selegiline do to dopamine metabolism?

Back 30

reduces metabolic inactivation of dopamine and thus increases straital CNS dopamine levels

Front 31

What are the side effects of selegiline?

Back 31

related to elevated CNS dopamine levels; at high doses it can inhibit MAO-A = risk of hypertensive response to tyramine ingestion; severe reactions when combined with SSRIs and tricyclic antidepressants

Front 32

What two drugs should not be combined with selegiline?

Back 32

tricyclic antidepressants and SSRIs

Front 33

What is the action of Catechol-O-Methyltransferase inhibitors in the treatment of Parkinson's?

Back 33

they increase the amount of levodopa that reaches the CNS by blocking peripheral metabolism or CNS metabolism

Front 34

What is the major side effect of tolcaptone?

Back 34

potential fatal hepatoxicity- severely limits its use

Front 35

What is the action of muscarinic receptor antagonists in the treatment of Parkinson's?

Back 35

they block cholinergic mechanisms in the striatum that are normally oposed by tonic release of dopamine

Front 36

What is the clinical effect of trihexyphenidyl, benztropine and biperdien?

Back 36

improve tremor and rigidity but do not improve bradykinesia

Front 37

When are trihexyphenidyl, benztropine and biperdien used?

Back 37

early in the disease and as adjuvants to levodopa therapy

Front 38

What are the side effects of trihexyphenidyl, benztropine and biperdien?

Back 38

peripheral effects due to muscarinic blockade: cycloplegia, dry mouth, urinary retention etc

Front 39

Which patients should NOT receive trihexyphenidyl, benztropine or biperdien?

Back 39

patients with prostatic hyperplasia and angle-closure glaucoma and patients who are taking other antimuscarinic drugs (tricyclic antidepressants, or anti-histamines)

Front 40

What is the ONLY class of drug that effectively treats anti-psychotic drug induced parkinsonism?

Back 40

selective CNS muscarinic receptor antagonists - trihexyphenidyl, benztropine, biperdien

Front 41

What is amantadine used for?

Back 41

initial therapy - has short effective course of action

Front 42

Amantadine can help with what when given with levodopa?

Back 42

helps reduce dose related response fluctuations

Front 43

What are the side effects of amantadine?

Back 43

usually CNS type of effects - reversible and mild; dermatological reactions - ankle edema and livedo reticularis

Front 44

What is the major adverse effect of tacrine?

Back 44

major hepatic toxicity

Front 45

What are the side effects of tacrine?

Back 45

loss of appetite, abdominal pain, nausea, vomiting, diarrhea

Front 46

What is the duration of tacrine?

Back 46

6-8 hours

Front 47

What is the half life of donepezil?

Back 47

long - allows once per day dosing

Front 48

What effects does donepezil have on the liver?

Back 48

No hepatoxicity (as seen with Tacrine)

Front 49

What are the side effects of donepezil?

Back 49

nausea, vomiting, diarrhea

Front 50

How often are rivastigmine and galantamine administered?

Back 50

Twice daily

Front 51

How often is Riluzole given?

Back 51

Twice daily

Front 52

What are the side effects of Riluzole?

Back 52

nausea or diarrhea