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Pharmacology Exam III > Anti-Parkinsonian Drugs > Flashcards

Anti-Parkinsonian Drugs Flashcards

1
Q

4 Cardinal Signs of Parkinsons

A

Bradykinesia
Muscular rigidity
Resting tremor
Postural Instability

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2
Q

Pathophysiology of Parkinsons

A

degeneration/loss of DOPAMINERGIC NEURONS IN SUBSTANTIA NIGRA that project to the STRIATUM

increased activity of cholinergic pathways as a result

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3
Q

Abnormal protein in Parkinsons

forms?

A

ALPHA-SYNUCLEIN

LEWY BODIES

potentially free radical production as well

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4
Q

5 Treatment Strategies of Parkinsons

A 
DA Replacement
DA Receptor Agonists
L-DOPA Degradation INHIBITORS
Increase DA Release
Anti-cholinergic agents
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5
Q

L-DOPA

A

MOST COMMON DRUG TO TREAT PARKINSONS

BENEFITS DIMINISH AFTER 3-4 YEARS

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6
Q

Carbidopa

A

INHIBITOR OF DOPA DECARBOXYLASE in periphery

inhibits premature breakdown of levodopa

reduces amount of levodopa needed for therapeutic response

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7
Q

L-DOPA Adverse Effects

What is one method to counter some of the adverse effects?

A

Dyskinesias
Response Fluctuations - wearing off, on-off phenomenon

Drug Holiday

GI, Cardio, Behavioral as well

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8
Q

Drug Interactions with L-DOPA

A 
B6
MAO-A Inhibitors - NE levels
Antipsychotics
Protein-rich meals
Anti-cholinergics
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9
Q

Dopamine Receptor Agonists (3)

A

Pramipexole
Ropinirole
Apomorphine

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10
Q

Dopamine Receptor Agonist clinical info

A

can be used as FIRST LINE THERAPY or MONOTHERAPY for mild parkinsonism

Associated with LOWER INCIDENCE OF RESPONSE FLUCTUATIONS/DYSKINESIS

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11
Q

Adverse Effects of Dopamine Receptor Agonists

A

GI (MORE COMMON)

CV
Dyskinesias
Behavioral/Mental
Headache
Impulse Control Problems (prefrontal cortex, nucleus accumbens) - reward pathways --> DOPAMINE signaling
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12
Q

L-DOPA Degradation Blockers
MAO-B Inhibitors

Clinical (1)

Adverse (2)

A 
Rasagiline
Selegiline (at lower doses)

Adjunctive to levodopa primarily

GI upset
Serotonin Syndrome

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13
Q 
L-DOPA Degradation Inhibitors
COMT Inhibitors (2)

Which is preferred? Why?

A

Entacapone
Tolcapone

Entacapone - no assocation with hepatotoxicity

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14
Q

Increased Dopamine Release drug

Clinical

A

Amantadine

short duration and short lived therapeutic effectiveness

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15
Q

Anticholinergic agents for Parkinsons (2)

Clinical effect

A

Benzatropine
Trihexyphenidyl

Reduces TREMOR AND RIGIDITY

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Pharmacology Exam III (11 decks)

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