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Pharamcology > Anti Parkinsion Drugs > Flashcards

Anti Parkinsion Drugs Flashcards

1
Q

Classify anti Parkinson drugs

A
  1. Dopamine precursors
  2. dopamine agonists
  3. NMDA receptor antagonists
  4. MAO-B inhibitors
  5. COMT inhibitors
  6. centrally acting anticholinergic drugs
  7. anti-histamines with anticholinergic activity
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2
Q

Name a precursor of dopamine that does not cross the blood brain barrier and act as a pro drug

A

Levodopa

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3
Q

Which enzyme converts levodopa into dopamine 

A

Decarboxylase 

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4
Q

Levodopa is used in combination with which drugs

A

Carbidopa/ Benserazide

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5
Q

Why is levodopa given 30 to 60 minutes before meals

A

Because amino acids present in the food interfere with absorption of levodopa

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6
Q

What are the metabolites of levodopa

A

Homovanillic acid (HVA)
3,4- dihydroxyphenylacetic acid (DOPAC)

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7
Q

What are the adverse effects of levodopa

A
  1. GIT: nausea, vomiting, anorexia
  2. CVS: postural hypotension, tachycardia, palpitation and rarely cardiac arrhythmias
  3. Alteration in taste sensation
  4. Dyskinesias
  5. CNS: Mental changes
  6. Fluctuations in response
    
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8
Q

What is the ratio of using levodopa with carbidopa / benserazide 

A

Levodopa : carbidopa / benserazide
4:1

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9
Q

Bromocriptine is contraindicated in which patients

A

Patient with a history of
1. mental illness
2. recent MI
3. peptic ulcers
4. peripheral vascular disease

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10
Q

Which drug rarely causes fulminant hepatitis and should be avoided in patients with liver disease?

A

Tolcapone

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11
Q

What are the metabolites of selegiline

A

amphetamine and methamphetamine

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12
Q

Which anti- Parkinson’s drug is also an antiviral that is used for the treatment and prophylaxis of influenza A

A

Amantadine

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13
Q

What are the side effects of amantadine

A
  1. Headache, heart failure, hypotension, hallucinations, nausea, vomiting, constipation, dry mouth and insomnia
  2. Livedo reticularis (discoloured patches on the skin)
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14
Q

Which group anti-Parkinson’s causes blurring vision and urinary retention as an adverse effect

A

Anti cholinergic drugs ( benzhexol [trihexyphenidyl] and benztropine)

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15
Q

Levodopa is not active in drug induced parkinsonism, why?

A
  1. Dopamine receptors are blocked
  2. There is no deficiency of dopamine
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16
Q

What is the advantage of using levodopa with MAO inhibitors

A

Retards metabolism Of dopamine And increases plasma concentration of dopamine. 

17
Q

Why should we avoid prescribing levodopa with pyradoxine?

A

Pyradoxine Promotes conversion of levodopa to dopamine and reduces it’s therapeutic effect

18
Q

Should levodopa be given with anti-hypertensive agents?

A

No because it worsens postural hypotension

19
Q

What happens when levodopa is given with metoclopramide?

A

It crosses BBB, blocks D2 receptors in the basal ganglia and causes drug induced Parkinsonism

20
Q

Which drugs can be used to treat Tremors

A
  1. Beta blockers
  2. antiepileptic drugs
  3. botulinum toxin
21
Q

Which drugs can be used to treat Tremors

A
  1. Beta blockers (Propranolol metoprolol)
  2. antiepileptic drugs (Gabapentin, primidone, topiramate)
  3. botulinum toxin
22
Q

What are the drugs used for the treatment of Huntingtons disease

A
  1. Amine depleting drugs (reserpine, tetrabenazine)
  2. Dopamine receptor antagonists (haloperidol, perphenazine)
  3. Olanzapine
    
23
Q

What drugs are used for the treatment of Tourette’s syndrome

A
  1. Dopamine D2 antagonists
  2. Carbamazepine
  3. Clonazepam
  4. Clonidine 
24
Q

Which drugs are used for the treatment of drug-induced dyskinesis? Why can’t levodopa and bromocriptine be used

A
  1. Benztropine Or diphenhydramine

Because dopamine receptors are blocked by antipsychotic drugs

25
Q

What are the drugs of choice for tardive dyskinesias?

A

VMAT2 inhibitors (Deutetrabenazine and valbenazine) transporters of dopamine release

26
Q

Which drugs are used in the treatment of Wilson’s disease

A
  1. Penicilliamine
  2. Trientine
  3. Tetrathiomolybdate
27
Q

What are the adverse effects of penicillamine

A
  1. G.I. distress
  2. myasthenia
  3. optic neuropathy
  4. blood dyscrasias
28
Q

What drugs are used in restless legs syndrome

A
  1. Pramipexole and ropinirole
  2. opioid analgesics
  3. Benzodiazepines
  4. Certain anticonvulsant
29
Q

Which dopamine receptor agonist is an ergot Derivative

A

Bromocriptine

30
Q

Which dopamine receptors are non-ergo line derivatives

A

Pramipexole
Ropinirole

Pharamcology (15 decks)

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