Anti-Parkinsons Agents

Question 1

Levodopa (L-DOPA)

Answer 1

Most common drug used to Tx Parkinson’s

Improves PD symptoms (esp. bradykinesia and rigidity)

Benefits start to diminish after 3-4 years of therapy

SE: dyskinesia, GI disturbance, CV, behavioral

Question 2

Carbidopa

Answer 2

Inhibitor of Dopa decarboxylase in the periphery

Usually administered w/ L-DOPA

Question 3

Pramipexole

Answer 3

Dopamine Receptor Agonist

MOA: Selective D2 receptor agonist

Rx: Parkinsons

Question 4

Ropinirole

Answer 4

Dopamine Receptor Agonist

MOA: Selective D2 receptor agonist

Rx: Parkinsons

Question 5

Apomorphine

Answer 5

Dopamine Receptor Agonist

MOA: Selective D2 receptor agonist

Rx: Parkinsons

Question 6

Rasagiline

Answer 6

MAO-B Inhibitor

MOA: Inhibits MAO-B selectively at low doses; decreases breakdown of dopamine

Rx: Parkinsons (adjunctive to L-DOPA)

SE: Upset GI, Serotonin syndrome

Question 7

Selegiline

Answer 7

MOA: Inhibits MAO-B selectively at low doses; decreases breakdown of dopamine

Rx: Parkinsons (adjunctive to L-DOPA)

SE: Upset GI, Serotonin syndrome

Question 8

Entacapone

Answer 8

COMT Inhibitor

MOA: peripheral COMT inhibition (no CNS entry)

Rx: adjunct Tx w/ L-DOPA

Question 9

Tolcapone

Answer 9

COMT Inhibitor

MOA: central and peripheral COMT inhibition

Rx: adjunct Tx w/ L-DOPA

SE: acute hepatic failure!

Question 10

Amantadine

Answer 10

Antiviral Agent

Short-lived antiparkinsonism properties via DA release

SE: Livedo reticularis (blotchy reddened pattern, usually on legs)

Question 11

Benztropine

Answer 11

Anticholinergic Agent

Reduces tremor / rigidity; little effect on bradykinesia

Question 12

Trihexyphenidyl

Answer 12

Anticholinergic Agent

Reduces tremor / rigidity; little effect on bradykinesia

Question 13

PD accumulations

Answer 13

Intracytoplasmic alpha-synuclein aggregates