Sketchy Pharm: Levodopa/Carbidopa... Flashcards
Why can’t you just give dopamine to people with Parkinson’s?
Because it doesn’t cross the BBB, while levodopa does
What activates L-DOPA?
Decarboxylation
Dopamine in the periphery leads to what side effects?
Nausea (the tied up hostage about to vomit OUTSIDE the vault), postural hypotension (the hostage about to faint)
Central side effects of dopamine include ____________.
anxiety and hallucinations (the hostage freaking out… not sure why he’s not in the vault)
Chronic side effects of levodopa use include ______________.
wearing-off effects at the end of each dosing period (the tapering, worn out rope) and an on-off appearance of Parkinson’s symptoms
Long-term use of levodopa unfortunately leads to ____________ of the therapeutic window.
narrowing
Avoid the use of levodopa in _______________.
patients with psychosis
Why might you administer a COMT inhibitor with carbidopa?
Because COMT can methylate (and thus inactivate) levodopa!
COMT inhibitors include ____________.
entacapone (the “entrance guy”) and tolcapone (the tall gangster in Al CAPONE’s gang)
Why is entacapone generally preferred over tolcapone?
Because tolcapone has a risk of hepatotoxicity (think of the TaLl gangster’s hepatic clip on his tommy gun)
What action does ropinirole have?
D2 receptor agonist (rope – as in dope rope –in a roll)
Pramipexole is a _____________.
D3 agonist
What are the indications for D2/D3 agonists?
Restless leg syndrome (guy shaking his leg climbing up the ladder)
Early Parkinson’s (has been shown to decrease need for levodopa treatment)
Side effects of ropinirole include ______________.
gambling, hypersexuality, and impulse control (ropinirole = rock n’ roll)
What is the mechanism of amantadine?
It releases and enhances endogenous dopamine (think of the MANaTee statue breaking open the box of DOPe rope)
