67 Pharmacology: Alzheimer and Parkinson Drugs

Question 1

Parkinson Drugs

• What are the dopamine precursors?

Answer 1

Question 2

Parkinson Drugs

• What are the dopamine receptor agonists?

Answer 2

Question 3

Parkinson Drugs

• What are the inhibitors of dopamine metabolism?

Answer 3

Question 4

Parkinson Drugs

• What are the anticholinergics used for Parkinson Disease?

Answer 4

Question 5

Parkinson Drugs

• What is the antiviral used for Parkinson Disease?

Answer 5

Question 6

Parkinson Drugs

• What is the precursor to L-DOPA?
• What converts L-DOPA to dopamine?

Answer 6

Question 7

Parkinson Drugs

• Levodopa
  
  • Where is most of the oral dose absorbed?
  • Where is most of the oral dose metabolized?
    
    • What percent actually reaches circulation?
  • How much of an absorbed dose actually is converted to dopamine in the CNS?
    
    • How much is converted to dopamine in the periphery?

Answer 7

Question 8

Parkinson Drugs

• Levodopa + Carbidopa
  
  • What is carbidopa?
    
    • Where does it act?
    • How is the dose calculated?
  • How does Levodopa + Carbidopa increase circulation concentrations compared to Levodopa without Carbidopa?
    
    • What about CNS absorption?

Answer 8

Question 9

Parkinson Drugs

• Levodopa + Carbidopa
  
  • What symptom is most relieved about this?
  • What is NOT prevented with this?
  • When are the benefits of therapy greatest?
    
    • When do benefits diminish?
      
      • What are the 3 reasons for this?

Answer 9

Question 10

Parkinson Drugs

• Levodopa + Carbidopa
  
  • ADRS
    
    • What set of ADRs decreases when Levodopa is used with Carbidopa?
    • What set of ADRs increases when Levodopa is used with Carbidopa?
    • What ADR is related to an increase of catecholamines in the periphery?
  • Contraindications
    
    • What mental illness is contraindicated?
    • What abdominal condition is contraindicated?
    • What kind of patient history is contraindicated?

Answer 10

Question 11

Parkinson Drugs

• Dopamine Receptor Agonists​
  
  • What is the MOA for these drugs?
  • Compared to Levodopa + Carbidopa, these have 3 benefits. What are they?
  • ADRS
    
    • What 6 sets of ADRs exist with these drugs?

Answer 11

Question 12

Parkinson Drugs

• MAO I Inhibitors
  
  • What drugs fall under this category?
  • What do these drugs inhibit the conversion of?
  • Which MAO I Inhibitor is used as a monotherapy?
    
    • When?
  • How do these drugs relate to levodopa/carbidopa?
    
    • What levodopa/carbidopa ADR is REDUCED when using MAO I Inhibitors?
    • Which levodopa/carbidopa ADR is INCREASED when using MAO I Inhibitors?
  • Other ADRS
    
    • Which MAO I Inhibitors has a similar ADR to Adderall?
      
      • Why?
    • What does inhibiting MAO in the GI tract do?
    • What syndrome can occur with MAO I Inhibitor use?

Answer 12

Question 13

Parkinson Drugs

• COMT Inhibitors
  
  • What 2 drugs fall under this category?
    
    • Which drug exclusively works in the periphery, and which one works in both the CNS and periphery?
  • What reaction do these drugs inhibit?
  • How do these drugs relate to levodopa/carbidopa?
    
    • What ADR is reduced?
    • Which ADRs are increased?
  • Other ADRS
    
    • What ADR is related to urine, and which COMT inhibitor does this?
    • What black box label warning exists, and which COMT inhibitor is this for?
  • What is stavelo?

Answer 13

Question 14

Parkinson Drugs: Anticholinergics

• What are the 4 cholinergics?
• Where in the basal ganglia are MANY subtypes of M receptors found?
• What is the rational for using these in Parkinsons?
  
  • Do these affect tremor?
  • Do these affect bradykinesia?
• What are the ADRs for these?

Answer 14

Question 15

Parkinson Drugs: Amantadine

• What kind of drug is this, and what do it normal treat?
• Altohugh the MOA is unknown, what are the 4 general things it does that can be neuroprotective?
• Parkinsons
  
  • What does it benefit in Parkinsons?
    
    • How long does this act?
• ADRS
• What are the three sets of ADRs for this drug?

Answer 15

Question 16

Alzherimer’s Drugs

• What are the 4 acetylcholinestrase inhibtors for this?
  
  • Which ones are reversible and which ones are irreversible?

Answer 16

Question 17

Alzherimer’s Drugs

• What NMDA receptor antagonist is used for this?

Answer 17

Question 18

Alzherimer’s Drugs: Acetylcholinesterase Inhibitors

• MOA
  
  • What are the ways things this does to treat AD?
• When are these indicated for AD?
• When do they become less affective?

Answer 18

Question 19

Alzherimer’s Drugs: Acetylcholinesterase Inhibitors

• ALL Drugs
  
  • What are teh 2 sets of ADRs for these drugs?
  • What conditions do you need to be sure to monitor? (3)
• Tacrine
  
  • What is the ADR specific for this drug that limits the usefullness of it?
• Galantamine
  
  • What do you need to absoultely NOT perscribe when using this drug?
• Donepezil
  
  • What is notable about the half life about this drug?
• Rivastigmine
  
  • What can decrease GI disturbances?

Answer 19

Question 20

Alzherimer’s Drugs: NMDA Receptor Antagonist

• Memantine
  
  • Is this a competetive or noncompetative antagonist?
  • MOA
    
    • What are the 2 general MOAs for this drug?
  • Administration
    
    • Can this drug be used by itself?
    • What can this combined with?
  • ADRS
    
    • What 2 sets of ADRs exist for this drug?

Answer 20