19 Pharm of Movement Disorders Flashcards

1
Q

MOA of bromocriptine

A

D2 agonist, D1 partial agonist

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2
Q

ADE of bromocriptine

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

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3
Q

MOA of pramipexole

A

D2 selective agonist. Free radical scavenger

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4
Q

ADE of pramipexole

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

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5
Q

MOA of ropinirole

A

D2 selective, metabolized by CYP1A2

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6
Q

ADE of ropinirole

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

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7
Q

MOA of amantadine

A

enhance DA release (antiviral). may also inhibit uptake. interact with NMDA receptors

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8
Q

ADE of amantadine

A

restlessness, depression agitation, hallucinationss. Overdose = psychosis

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9
Q

MOA of selegiline

A

MAO-B. inhibits DA metabolism

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10
Q

ADE of selegiline

A

may potentiate advese effects of L-DOPA

Do not give with meperidine, TCAs or SSRIs

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11
Q

MOA of rasagiline

A

MAO-B. inhibits DA metabolism. more potent than selegiline

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12
Q

ADE of rasagiline

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

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13
Q

MOA of entacapone

A

COMT. inhibits DA metabolism. Reduces production of 30MD which competes with L-DOPA for transport into BBB and GI.
Strictly has peripheral effects

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14
Q

ADE of entacapone

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

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15
Q

MOA of tolcapone

A

COMT. inhibits DA metab. has both peripheral and central effects. Entacapone is better.

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16
Q

ADE of tolcapone

A

hepatic failure and increased LFT

17
Q

MOA of benztropine

A

antimuscarinic

18
Q

ADE of benztropine

A

drowsiness, mental slowness, confusion, delusions, hallucinations
anticholinergic Dry mouth, blurred vision, mydriasis, urinary retention, N/V, constipation, tachycardia, arrhythmias.
Contraind in prostatic hyperplasia, OBD or gluacoma

19
Q

MOA of diphenhydramine

A

antimuscarinic

20
Q

ADE of diphenhydramine

A

drowsiness, mental slowness, confusion, delusions, hallucinations
anticholinergic Dry mouth, blurred vision, mydriasis, urinary retention, N/V, constipation, tachycardia, arrhythmias.
Contraind in prostatic hyperplasia, OBD or gluacoma

21
Q

MOA of trihexyphenidyl

A

antimuscarinic

22
Q

ADE of trihexyphenidyl

A

drowsiness, mental slowness, confusion, delusions, hallucinations
anticholinergic Dry mouth, blurred vision, mydriasis, urinary retention, N/V, constipation, tachycardia, arrhythmias.
Contraind in prostatic hyperplasia, OBD or gluacoma

23
Q

MOA of reserpine

A

VMAT inhibitor - depletes DA

24
Q

MOA of tetraenazine

A

VMAT inhibitor - depletes DA

25
Q

MOA of chlorpromazine

A

D2 receptor antagonist

26
Q

MOA of haloperidol

A

D2 receptor antagonist

27
Q

What is L-DOPA given with and why?

A

given with carbidopa, an L-AAD inhibitor that can not cross BBB to prolong L-DOPA and reduce amount requrired. Prevents conversion of L-DOPA to dopamine. Also reduces peripheral DA side effects.

28
Q

MOA of carbidopa

A

L-AAD inhibitor that prevents L-DOPA conversion to dopamine in the periphery.

29
Q

ADE of L-DOPA

A

GI (anorexia, N/V), tachycardia,orthostatic hypotension

30
Q

ADE of carbidopa

A

behavioral, dyskinesias in on-off phenomenon

31
Q

contraindications of L-DOPA

A

bitamin B6 increases L-DOPA metab so decarboxylase inhibitors must be given.
MAO-A inibhitors can cause hypertensive crisis with L-DOPA.
Contraindicated in psychotic, glaucoma and cardiac disesase or melanoma.

32
Q

MOA of apomorphine

A

D1/D2 agonist

33
Q

What are the D2 selective agonists?

A

pramipexole and ropinirole

34
Q

Contrainds of amantadine

A

seizures or heart failure patients

35
Q

What is a possible treatment of HD?

A

D2 antagonists, to stimulate indirect pathway.