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25 Cards in this Set

  • Front
  • Back
How does levodopa work?
It is an precursor to dopamine, metabolized to dopamine by dopa decarboxylase.
What is the main disadvantage of levodopa?
95% of it is metabolized in the periphery; only 2% reaches the brain.
What drug is given with levodopa to minimize peripheral consumption?
How does carbidopa work?
It inhibits dopa decarboxylase, but it can't cross the BBB so it doesn't affect levodopa in the brain.
What are some side effects of levodopa?
dyskinesias, N/V, postural hypotension, psychotic behavior
What are the drug interactions with levodopa?
with pyridoxine, increased peripheral metabolism of levodopa; with reserpine, depleted dopamine stores; with antipsychotics, blocked dopamine receptors; with MAOI, hypertensive crises; with anticholinergics, reduced GI absorption
What is the mechanism of action of bromocriptine?
It is a dopamine receptor 2 agonist.
What other disease does bromocriptine treat?
What are the side effects of bromocriptine?
involuntary movement, N/V, arrhythmias, postural hypotension
When is bromocriptine contraindicated?
in patients with recent MI or psychiatric illness
What may happen on the first dose of bromocriptine?
sudden cardiovascular collapse
Name three other dopamine agonists and which receptors they agonize.
Pergolide (D1 and D2), ropinerole (D2), pramipexole (D3)
What is the mechanism of action of amantadine with respect to treatment of parkinson's disease?
It stimulates the release of dopamine from presynaptic vesicles and delays reuptake.
What other disease does amantadine treat?
influenza A
What are the side effects of amantadine?
livedo reticularis, peripheral edema
What is the mechanism of action of selegiline (L-deprenyl)?
It is an inhibitor of MAO-B.
What is MAO-B?
monoamine oxidase B, only metabolizes dopamine
Why would you give anticholinergic drugs to a patient with parkinsonism?
Dopamine usually inhibits cholinergic neurons in the striatum, so when it's gone, there's too much cholinergic activity.
Name some anticholinergic drugs.
benztropine, biperiden, orphenadrine, procyclidine, trihexyphenidyl
What are the side effects of anticholinergic drugs?
sedation, confusion, dry mouth, constipation, urinary retention, blurred vision, tachyarrhythmias
What are the drug interactions with anticholinergics?
tricyclic antidepressants, antihistamines
What do you give for tremor?
beta-blockers - propranolol
What do you give for Huntington's disease?
neuroleptics - haloperidol and the phenothiazines (both block dopaminergic receptors)
What do you give for Tourette syndrome?
neuroleptics - haloperidol (D2 receptor blockers)
What causes Huntington's disease?
degeneration of striatal GABA-ergic and cholinergic neurons; deficiency of cholinergic function