CNS DRUGS - PARKINSON DRUGS

Question 1

neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra

Answer 1

Parkinson Disease

Question 2

pathological hallmark of Parkinson Disease is

Answer 2

• loss of the pigmented, dopaminergic neurons of the substantia nigra pars compacta - (+) appearance of intracellular inclusions known as LEWY BODIES

Question 3

The principal component of the Lewy bodies is aggregated _____

Answer 3

α - synuclein

Question 4

What are the primary signs of Parkinson Disease? PARKINSON DISEASE: It’s a TRAP!

Answer 4

Tremor Akinesia Rigidity Postural instability

Question 5

DOC for Parkinson disease

Answer 5

LEVODOPA-CARBIDOPA [C]

Question 6

What antipsychotics largely used as antiemetics SHOULD BE AVOIDED when taking L-dopa because it may exacerbate PD

Answer 6

PHENOTHIAZINE

• Typcal Antipsychotic
• CHLORPROMAZINE [C], THIOTHEXENE [C] (Thioxanthene), FLUPENTIXOL (Thioxantene), PROMETHAZINE, PROCHLORPERAZINE [C], LEVOMEPROMAZINE
• causes exacerbation of parkinson kasi diba problem nito is decreased dopamine? phenothiazine is a typical antipsychotic that block D2 receptors so lalong mawawala si dopamine

Question 7

occurs when LEVODOPA-CARBIDOPA is used with monoamine oxidase inhibitors

Answer 7

Hypertensive crisis

Question 8

MOA of LEVODOPA-CARBIDOPA [C]

Answer 8

Levodopa – dopamine precursor. Carbidopa – inhibits peripheral metabolism via dopa decarboxylase

Question 9

Examples of Anti-parkinsonism drug (dopamine agonist) MOA: Partial agonist at dopamine D 2 receptors in brain, D 2 agonism leads to inhibition of prolactin release

Answer 9

BROMOCRIPTINE [B] PERGOLIDE [B], CABERGOLINE [B], PIRIBEDIL

Question 10

Anti-parkinsonism drug (dopamine agonist) MOA: Partial agonist at dopamine D2 and D3 receptors in brain.

Answer 10

Partial agonist at dopamine D2 (PRAMIPEXOLE) and D3 receptors (ROPINIROLE) in brain.

Question 11

used for Restless legs syndrome, On-Off phenomenon

Answer 11

PRAMIPEXOLE [C] ROPINIROLE [C]

Question 12

side effects include Compulsive gambling, Hypersexuality, Overeating, Uncontrollable tendency to fall asleep

Answer 12

PRAMIPEXOLE [C] ROPINIROLE [C]

Question 13

Anti-parkinsonism drug (MAO type B inhibitor)

Answer 13

SELEGILINE [C] RASAGILINE [C]

Question 14

occurs when a MAO type B inhibitor is used with SSRIs, TCA and Meperidine

Answer 14

Serotonin syndrome

Question 15

occurs when a NON SELECTIVE MAOI is taken with tyramine-rich food such as cheese

Answer 15

HYPERTENSIVE CRISIS

Question 16

Anti-parkinsonism drug (COMT inhibitor)

Answer 16

ENTACAPONE [C] TOLCAPONE [C]

Question 17

Entacapone only acts in the ______ Tolcapone acts in _____

Answer 17

Entacapone only acts in the periphery while Tolcapone acts both in the periphery and CNS.

Question 18

Anti-parkinsonism drug that is also an Anti-influenza (antiviral)

Answer 18

AMANTADINE - used for influenza A only

MOA: Inhibit early step replication and prevent uncoating by binding to M2 proton channels

Question 19

A drug that causes LIVEDO RETICULARIS

Answer 19

AMANTADINE [C]

Question 20

What drugs can cause livedo reticularis?

Answer 20

HYDROXYUREA AMANTADINE MINOCYCLINE GEMCYTABINE QUINIDINE

Question 21

anti muscarinic agents used for Parkinson disease:

Answer 21

TRI (TRIhexiphenydyl) to PARK (drugs for PARKinsons) your BENZ (BENZtropine), BIP (BIPeriden) here.

Question 22

DRUGS FOR HUNTINGTON’S DISEASE MOA: Deplete amine transmitters especially Dopamine from nerve endings by reversibly inhibiting human vesicular monoamine transporter type 2 (VMAT2) resulting in decreased uptake of monoamines; reduces chorea severity; SE: hypotension, sedation, depression, diarrhea

Answer 22

TETRABENAZINE, RESERPINE

Question 23

DRUGS FOR TOURETTE’S SYNDROME MOA: Block central D 2 receptors, reduce vocal and motor tic frequency & severity ; SE: parkinsonism and other dyskinesias, sedation, blurred vision, dry mouth, GI disturbance, Pimozide may cause arrhythmia

Answer 23

HALOPERIDOL, PIMOZIDE