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Year 2 > Anti- Parkinson Drugs > Flashcards

Anti- Parkinson Drugs Flashcards

1
Q

What is the effect of a lesion in the extra pyramidal motor path?

A

Tremor at rest; Rigidity

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2
Q

What is the pathogenesis of Parkinson’s?

A

Loss of dopamine-secreting cells in the pars compact of the substantia nigra.

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3
Q

What are some iatrogenic causes of Parkinson’s?

A

Drugs that reduce dopamine activity.

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4
Q

Why do haloperidol and phenothiazines cause PD?

A

They block DA receptors.

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5
Q

Why do reserpine and tetrabenzine cause PD?

A

They deplete brain monoamines from storage sites.

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6
Q

Why does manganese poisoning cause PD?

A

It accumulates in the substantial nigra and interferes with enzyme systems. Oxidizes DA.

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7
Q

True or false: In PD the DA system is severely compromised and the cholinergic system operates unopposed?

A

True. Treatment thus involves restoring balance.

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8
Q

What does L-DOPA do?

A

It is a dopaminergic drug (precursor of DA) that increases DA activity.

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9
Q

Can L-DOPA cross the BBB?

A

Yes.

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10
Q

What is the response rate to L-DOPA and is it safe to use?

A

Response rate is high; Generally safe.

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11
Q

What are the adverse effects of L-DOPA?

A

Nausea, confusion

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12
Q

What does Carbidopa do?

A

Inhibits decarboxylase activity in the periphery. This prevents conversion of L-DOPA to DA.

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13
Q

Can Carbidopa cross the BB?

A

No.

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14
Q

How does Entacapone work?

A

It is a COMT inhibitor. Adjunct with L-DOPA. Entacapone prolongs L-DOPA action. Acts peripherally to reduce L-DOPA metabolism.

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15
Q

How does Tolcapone work?

A

COMT inhibitor. Acts peripherally and centrally.

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16
Q

What are the adverse effects of Tolcapone?

A

Can be hepatotoxic.

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17
Q

How does Amantadine work?

A

Enhances endogenous DA. It acts on release/synthesis/reuptake.

18
Q

True or false: Amantadine is also an anti-viral agent for the A2 influenza.

A

True.

19
Q

How does Bromocriptine work?

A

Agonist to D2 and partial antagonist to D1 receptors.

20
Q

True or false: Bromocriptine has a longer duration of action that L-DOPA.

A

True.

21
Q

When is Bromocriptine used?

A

Used as an adjunct in late treatment. Combats on/off effect.

22
Q

How does Pergolide work?

A

Agonist to D1 and D2 receptors. More potent than Bromocriptine.

23
Q

True or false: Pergolide has a longer duration of action that L-DOPA and less on/off effect.

A

True.

24
Q

How does Pramipexole work?

A

It is a DA agonist (D3). Used as adjunct with L-DOPA.

25
Q

When is Pramipexole used?

A

When the PD is mild.

26
Q

True or false: Pramipexole is possibly neuroprotective.

A

True. It scavenges H2O2.

27
Q

How does Ropinrole work?

A

It is a DA agonist (D2). Smoothes fluctuations in response to L-DOPA treatment.

28
Q

When is Ropinirole used?

A

When the PD is mild.

29
Q

What are the toxic side effects from L-DOPA mainly due to?

A

The conversion of L-DOPA to DA in the periphery.

30
Q

What are the toxic side effects of L-DOPA?

A

Nausea/vomiting, orthostatic hypotension, dyskinesia, mental effects.

31
Q

How does vitamin B6 reduce L-DOPA activity?

A

It increases dopa decarboxylase activity.

32
Q

What is the effect of MAO inhibitors?

A

They increase DA activity. MAOb breaks down DA. MAOa breaks down NE and 5HT in the CNS.

33
Q

Why can a high protein meal affect PD treatment?

A

It can interfere with the absorption of L-DOPA from the gut.

34
Q

True or false: Benserazide inhibits decarboxylase activity in the periphery and has a longer duration of action that carbidopa.

A

True.

35
Q

How does Selegiline work?

A

Increases DA activity by inhibiting MAO-B activity.

36
Q

Benzotropine, Biperiden, Orphenadrine, Procyclidine, and Trihexyphenidyl are what kind of drugs?

A

Anti-cholinergic drugs. They decrease Ach activity.

37
Q

What is the mechanism of action of the anti-cholinergic drugs?

A

They are all Ach (muscarinic) blockers.

38
Q

What is MPTP?

A

A drug that causes PERMANENT PD. It is a neurotoxin to substantia nigra cells.

39
Q

What does a Thalamotomy procedure do?

A

Reduces tremor.

40
Q

What does a Pallidotomy do?

A

Lessens motor fluctuations permanently.

41
Q

What dose Pallidal stimulator do?

A

Lessens fluctuations. Can be regulated.

Year 2 (9 decks)

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