19 Pharm of Movement Disorders Flashcards
MOA of bromocriptine
D2 agonist, D1 partial agonist
ADE of bromocriptine
GI (anorexia, N/V), tachycardia,orthostatic hypotension
MOA of pramipexole
D2 selective agonist. Free radical scavenger
ADE of pramipexole
GI (anorexia, N/V), tachycardia,orthostatic hypotension
MOA of ropinirole
D2 selective, metabolized by CYP1A2
ADE of ropinirole
GI (anorexia, N/V), tachycardia,orthostatic hypotension
MOA of amantadine
enhance DA release (antiviral). may also inhibit uptake. interact with NMDA receptors
ADE of amantadine
restlessness, depression agitation, hallucinationss. Overdose = psychosis
MOA of selegiline
MAO-B. inhibits DA metabolism
ADE of selegiline
may potentiate advese effects of L-DOPA
Do not give with meperidine, TCAs or SSRIs
MOA of rasagiline
MAO-B. inhibits DA metabolism. more potent than selegiline
ADE of rasagiline
GI (anorexia, N/V), tachycardia,orthostatic hypotension
MOA of entacapone
COMT. inhibits DA metabolism. Reduces production of 30MD which competes with L-DOPA for transport into BBB and GI.
Strictly has peripheral effects
ADE of entacapone
GI (anorexia, N/V), tachycardia,orthostatic hypotension
MOA of tolcapone
COMT. inhibits DA metab. has both peripheral and central effects. Entacapone is better.
ADE of tolcapone
hepatic failure and increased LFT
MOA of benztropine
antimuscarinic
ADE of benztropine
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
MOA of diphenhydramine
antimuscarinic
ADE of diphenhydramine
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
MOA of trihexyphenidyl
antimuscarinic
ADE of trihexyphenidyl
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
MOA of reserpine
VMAT inhibitor - depletes DA
MOA of tetraenazine
VMAT inhibitor - depletes DA
MOA of chlorpromazine
D2 receptor antagonist
MOA of haloperidol
D2 receptor antagonist
What is L-DOPA given with and why?
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.
MOA of carbidopa
L-AAD inhibitor that prevents L-DOPA conversion to dopamine in the periphery.
ADE of L-DOPA
GI (anorexia, N/V), tachycardia,orthostatic hypotension
ADE of carbidopa
behavioral, dyskinesias in on-off phenomenon
contraindications of L-DOPA
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.
MOA of apomorphine
D1/D2 agonist
What are the D2 selective agonists?
pramipexole and ropinirole
Contrainds of amantadine
seizures or heart failure patients
What is a possible treatment of HD?
D2 antagonists, to stimulate indirect pathway.