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Pharma > Anti-Parkinsonism Drugs > Flashcards

Anti-Parkinsonism Drugs Flashcards

1
Q

parkinson is a progressive or nonprogressive disease

A

progressive

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2
Q

cardinal signs of PD

A
  1. bradykinesia or akinesia
  2. tremors
  3. muscle rigdity
  4. postural imbalance
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3
Q

use of dopamine

A

as a NT in the brain for normal functioning of the extrapyramidal motor system (voluntary movement, balance)

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4
Q

pathophysiology of PD

A

reduction in Dopamine

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5
Q

pathological hallmarks of PD

A
  1. reduction in DA neurons in substantia niagra pars compacta
  2. inclusion of lewy bodies
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6
Q

NT levels in PD

A
  1. reduction in dopamine
  2. increase in ACh
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7
Q

aim of drug treatment in PD

A
  1. give drugs that increase DA levels
  2. give drugs that decrease ACh levels
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8
Q

anti PD drugs classification

A
  1. dopamine agonists
    - bromocriptine
    - ropinirole
    - pergolide
    - pramipexole
  2. Ach antagonists
    - benztropine
  3. MAO - B Inhibitors
    - selegiline
    - rasagiline
  4. COMT Inhibitors
    -entacapone
    - tolcapone
  5. sympathomimetics
    - adrenaline
  6. dopmaine precursor (L-DOPA)
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9
Q

Adverse effects of L-dopa

A

LEVODOPA

  1. lethargy
  2. excessive sleepiness, euphoria
  3. vomitting
  4. orthostatic hypotension
  5. delirium, delusion
  6. on and off phenomenon
  7. psychosis
  8. athetosis
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10
Q

contraindications of L-dopa

A

P^G^S^

  1. peptic ulcer disease
  2. psychosis
  3. glaucoma
  4. gout
  5. skin lesions
  6. severe cvs disease like hypotension and arrythmias
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11
Q

drug interactions of L-dopa

A
  1. Anti-psychotics
    - decrease the effect of l-dopa as they are DA-antagonits
  2. Pyroxidine
    - increases L-dopa metabolism, so decreases its effect
  3. MAO inhibitors
    - cause hypertensive effect due to increased levels of catecholamines
  4. sympathomimetics
    - decrease absorption of L-dope from GIT
  5. anti-cholinergic drugs
    - decrease absorption of L-dope from GIT
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12
Q

L-dopa used in combination with

A

carbidopa

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13
Q

benefits of CT with carbidopa

A
  1. increased half life of L-dopa
  2. decreased dose needed
  3. reduced adverse effects
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14
Q

ergot derived dopamine agonists

A
  1. bromocriptine
  2. pergolide
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15
Q

non-ergot derived dopamine agonists

A
  1. ropinirole
  2. pramipexole
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16
Q

adverse effects of ergot derived DA agonists

A
  1. cardiac valvulopathy
  2. pericardia, pulmonary, retroperitoneal fibrotic reactions
17
Q

advantages of dopamine agonists

A
  • can be given in patients who dont have the capacity to convert L-dope to dopamine anymore
  • do not require enzymatic conversion to active metabolie
  • no toxic metabolites
  • no competition for active trasport across bbb
  • cause less dyskinesias
18
Q

advantage of CT of L-dopa

A

reduction in wearing phenomenon

19
Q

side effects of dopamine agonists

A
  • fatigue
  • somnolence
  • nausea
  • orthostatic hypotension
  • hallucinations
  • confusion
20
Q

contraindications of dopamine agonists

A
  1. peptic ulcer disease
  2. psychosis
  3. peripheral vascular disease
21
Q

does ldopa or DA agonist cause more dyskinesia?

A

l-dopa

22
Q

is monotherapy of comt inhibitors allowed

A

NO

23
Q

one anti-parkinson drug that does not have monotherapy

A

comt inhibitors

24
Q

orange discoloraton of urine is a side effect of whic anti-PD drug

A

comt inhibitors

25
Q

is monotherapy of mao inhibitors possible

A

YES

26
Q

what is a specific side effect of selegiline

A

production of **amphetamine metabolites **
- nausea
- confusion
- nightmares
- vivid dreams
- hallucinations
- postural hypotension

27
Q

which mao inhibitor prodcuces amphetamine metabolites

A

selegiline

28
Q

which anti-pd drug shows initial flu-like symptoms

A

rasagiline

29
Q

one specific side effect of rasagiline

A

flu-like symptoms

30
Q

mechanism of action of amantidine

A

blocks NMDA glutamate receptors and is anticholinergic

31
Q

whic anti-PD is used as** initial therapy for mild PD**

A

amantidine

32
Q

side effects of anti-choliergic drugs

A
  1. dry mouth
  2. blurred vision
  3. urine retention
  4. constipation
33
Q

anti-cholinergic drugs in treatment of pd

A
  1. benztropine (cogentin)
  2. trihexyphenidyl
  3. orphenadrine
34
Q

main therpeutic effect produced by anti-cholinergic in pd

A

reduction of tremors and rigidity but not bradykinesia

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