Antiparkinson Drugs Flashcards
Achalasia
Failure to relax, usually referring to the smooth muscle fibers of the GI tract, especially failure of the lower esophagus to relax, causing difficulty swallowing and a feeling of fullness in the sternal region
Akathisia
Extreme restlessness and increased motor activity
Blood-brain barrier
Ability of the nervous system to prohibit large and potentially harmful molecules from crossing the blood to the brain
Bradykinesia
Slow movement
Choreiform movements
Involuntary muscular twitching of the limbs or facial muscles
Dystonic
Muscular spasm most often affecting the tongue, jaw, eyes, and neck
Extrapyramidal symptoms (EPS)
Group of adverse reaction involving the extrapyramidal portion of the nervous system causing abnormal muscle movements, especially akathisia and dystonia
On-off phenomenon
Fluctuation in levodopa therapy where inconsistent absorption causes alternating improved status and loss of therapeutic effect
Parkinsonism
Referring to a cluster of symptoms associated with Parkinson disease (fine tremors, slowing of voluntary movements, muscular weakness)
Parkinson’s disease
Degenerative disorder caused by an imbalance of dopamine and acetylcholine in the CNS
Restless leg syndrome
Disorder with an irresistible urge to move legs, urge lessens with movement but worsens with rest
Cardinal signs of Parkinson’s disease
Trembling, rigidity, difficulty walking, problems with balance, and bradykinesia
Dopaminergic drugs ex
Levodopa, carbidopa, amantadine, bromocriptine, or MAOIs (selegiline, rasagiline)
Dopaminergic Drugs MOA
Stimulate dopamine receptors or increase availability of dopamine
Dopaminergic Drugs uses
Parkinson disease, Parkinson like symptoms, restless leg syndrome, viral infections
Dopaminergic Drugs side effects
Dry mouth, diffupiculty swallowing, anorexia, nausea, vomiting, abdominal pain, constipation, increased had tremor, headache, dizziness
Levodopa side effects
Choreiform movements and dystonic movements, dementia, depression, psychotic episodes, paranoia, and suicidal tendencies
Levodopa contraindications
Narrow angle glaucoma, and MAOIs
Patients taking levodopa should be screened for
Unusual skin lesion
Levodopa precautions
Cardiovascular or pulmonary disease, peptic ulcer disease, renal or hepatic disease, and psychosis, pregnancy (cat C), and lactation
Dopaminergic Drugs interactions
TCAs increase risk of hypertension and dyskinesia
Levodopa interactions
Antacids increase levodopa effect, and anti-epileptics and and foods high in vitamin B6 decrease levodopa’s effect
Dopamine receptor Agonists MOA
Act directly on postsynaptic dopamine receptor of nerve cells in the brain, mimicking effects of dopamine
Dopamine receptor Agonists use
Treatment of the signs and symptoms of Parkinson’s disease, and RLS
Dopamine receptor Agonists ex
Gabapentin encarbil, and apomorphine, ropinirole, pramipexole
Dopamine receptor Agonists side effects
Nause, vomiting, dizzy, somnolence, hallucinations, confusion, visual disturbance, postural hypotension, abnormal involuntary movements, headache
Dopamine receptor Agonists precautions
Dyskinesia, orthostatic hypotension, hepatic or renal impairment, cardiovascular disease, and a history of hallucinations or psychosis
Ropinirole pregnancy cat
C
Pramipexole pregnancy cat
C
Dopamine receptor Agonists interactions
Increased risk of CNS depression, increased effects of levodopa and hallucinations, and ciprofloxacin, cimetidine, ranitidine, verapmil, and quinidine and estrogen increase dopamine agonist effectiveness, and phenothiazines decrease dopamine agonist effectiveness
COMT inhibitors ex
Entacapone, tolcapone
COMT inhibitors MOA
Prolong effect of dopamine by blocking COMT enzyme, which eliminates dopamine
COMT inhibitors uses
Used as adjuncts to levodopa/carbidopa
Entacapone use
Help manage fluctuations in response to levodopa, mild COMT inhibitor
Tolcapone side effects
Liver damage and liver failure, potent COMT inhibitor
COMT inhibitors side effects
Dizziness, dyskinesia, hyperkinesias, akathisia, nausea, anorexia, diarrhea, orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, muscle cramps
COMT inhibitors contraindications
Pregnancy (cat C) lactation
Tolcapone contraindications
Liver dysfunction
COMT inhibitors precautions
Hypertension, hypotension, decreased hepatic or renal function
COMT inhibitor interactions
MAOI increases toxicity risk of both drugs, adrenergic drugs increase risk of cardiac symptoms
What should be used in older patients to treat Parkinson’s
Antihistamines to produce fewer adverse reactions
Cholinergic blockers for Parkinson’s side effects
Dry mouth, blurred vision, dizziness, Mild nausea, nervousness
Cholinergic blocking drugs used for Parkinson’s contraindications
Angle closure glaucoma, pyloric or duodenal obstruction, peptic ulcers, prostatic hypertrophy, achalasia, myasthenia gravis and megacolon
Cholinergic blocking drugs for Parkinson’s precautions
Tachycardia, cardiac arrhythmias, hypertension, hypotension, tendency towards urinary retention, decreased liver or kidney function, obstructive disease of urinary system or GI tract, or elderly
Cholinergic blocking drugs for Parkinson’s interactions
Amantadine increases anticholinergic effects, increased digoxin serum levels, haloperidol increases psychotic behavior, phenothiazines increase anticholinergic effects
Cholinergic blocking drugs used for Parkinson’s ex
Benztropine, diphenhydramine, trihexyphenldyl
