12. Drugs for Parkinsons Disease Flashcards
The following are what kind of drugs are movement disorders (parkinsons disease mainly)?
Levodopa
Carbidopa
Levodopa+Carbidopa
Levodopa and combinations
The following are what kind of drugs are movement disorders (parkinsons disease mainly)? Apomorphine Bromocriptine Pramipexole Ropinirole
Dopamine Receptor Agonists
The following are what kind of drugs are movement disorders (parkinsons disease mainly)?
Rasagiline
Selegiline
Safinamide
Monoamine Oxidase Inhibitors
The following are what kind of drugs are movement disorders (parkinsons disease mainly)? Benztropine Biperiden Orphenadrine Procyclidine Trihexyphenidyl
Anticholinergic Drugs
The following are what kind of drugs are movement disorders (parkinsons disease mainly)?
Riluzole
Reserpine/Tetrabenazine
Misc Agents
What drug is a dopamine agonist and peaks 1-2 hours, in which given with another drug reduces the daily requirments by 75%, approved for parkinsons disease, does not stop progression, increasing dose causes development of dyskinesias (distortion/impairment of voluntary movement), when combined causes less GI issues, postural hypotension and HTN seen, dyskinesias MC** -choreoathetosis of face and distal extremities is MC, may cause behavioral defects, also may cause wearing off phenomenon or on-off phenomenon?
Levadopa + Carbadopa = LESS SIDE EFFECTS
Levadopa is contraindicated in patients on MOAIs within two weeks of discontinuing due to causing HTN crisis, contraindication in psychotic patients, angle closure glaucoma, hx of what skin cancer?
Melanoma
Dopamine receptor agonists lower response fluctuations and dyskinesias that occur w long term levodopa therapy, for patients on levodopa who have end of dose akinesia or on-off phenomenon. What drug is an ergot alkaloid D2 agonist approved for hyperprolactinemia?
Bromocriptine
What is when there are off periods of marked akinesia alternate over the course of a few hours with on-periods of improved mobility but often marked dyskinesia, apomorphine injections can help with severe cases?
On-off phenomenon
Ropinirole is a D2 receptor agonist approved for tx of RLS (restless leg syndrome), CYP1A2 metabolism, what drug has affinity for D3 receptor, and is for mod-severe restleess leg syndrome?
Pramipexole
DA receptor agonists have same SE as levodopa
Monoamine oxidase has two forms.. A: metabolizes NE and epi, B: metabolizes phenylthlamine and benzylamine, and both equally metabolize dopamine and tryptamine, what drug is selective MOAI - B selective = slows breaking down of dopamine and prolongs levodopa effects - contraindicated in pt taking meperidine, TCAs or SSRIs?
Selegiline/Rasagiline/Safinamide (all same)
***AVOID non-selective MOAIs with levodopa d/t risk of HTN crisis
What Catechol-O-Methyltransferase (COMT) inhibitors metabolize levodopa to 3-o-methyldopa which competes with levodopa in GI and BBB, thus prolonging the activity of levodopa by inhibiting its metabolism , one is peripheral acting and one is peripheral and central acting, SE mainly due to Ldopa but include orange urine, diarrhea?
Tolcapone- central/peripheral acting
Entacapone- peripheral acting only
Hepatotoxicity SE
What drug has a MOA of dopamine agonist at D2 receptors, injected SUBCUTANEOUSLY for quick relief of off periods of akinesia in pt on dopaminergic therapy (Ldopa), SE include nausea, bruising, dyskinesias, drowsiness?
Apomorphine
What drug is an antiviral agent with an unknown MOA (may potentiate dopaminergic function), may cause livedo reticularis ( vascular condition characterized by purplish mottled discoloration of the skin on legs) along with depression, irritability, insomnia and headache?
Amantadine
What group of drugs are centrally acting mAChR antagonists and availible to treat pt with PD, improving tremor and rigidity but little effect on bradykinesia?
Anticholinergic drugs = Benztropine Biperiden Orphenadrine Procyclidine Trihexyphenidyl
