CNS DRUGS - PARKINSON DRUGS Flashcards
neurodegenerative disease caused by degeneration of dopaminergic neurons in the substantia nigra
Parkinson Disease
pathological hallmark of Parkinson Disease is
- loss of the pigmented, dopaminergic neurons of the substantia nigra pars compacta - (+) appearance of intracellular inclusions known as LEWY BODIES
The principal component of the Lewy bodies is aggregated _____
α - synuclein
What are the primary signs of Parkinson Disease? PARKINSON DISEASE: It’s a TRAP!
Tremor Akinesia Rigidity Postural instability
DOC for Parkinson disease
LEVODOPA-CARBIDOPA [C]
What antipsychotics largely used as antiemetics SHOULD BE AVOIDED when taking L-dopa because it may exacerbate PD
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
occurs when LEVODOPA-CARBIDOPA is used with monoamine oxidase inhibitors
Hypertensive crisis
MOA of LEVODOPA-CARBIDOPA [C]
Levodopa – dopamine precursor. Carbidopa – inhibits peripheral metabolism via dopa decarboxylase
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
BROMOCRIPTINE [B] PERGOLIDE [B], CABERGOLINE [B], PIRIBEDIL
Anti-parkinsonism drug (dopamine agonist) MOA: Partial agonist at dopamine D2 and D3 receptors in brain.
Partial agonist at dopamine D2 (PRAMIPEXOLE) and D3 receptors (ROPINIROLE) in brain.
used for Restless legs syndrome, On-Off phenomenon
PRAMIPEXOLE [C] ROPINIROLE [C]
side effects include Compulsive gambling, Hypersexuality, Overeating, Uncontrollable tendency to fall asleep
PRAMIPEXOLE [C] ROPINIROLE [C]
Anti-parkinsonism drug (MAO type B inhibitor)
SELEGILINE [C] RASAGILINE [C]
occurs when a MAO type B inhibitor is used with SSRIs, TCA and Meperidine
Serotonin syndrome
occurs when a NON SELECTIVE MAOI is taken with tyramine-rich food such as cheese
HYPERTENSIVE CRISIS
Anti-parkinsonism drug (COMT inhibitor)
ENTACAPONE [C] TOLCAPONE [C]
Entacapone only acts in the ______ Tolcapone acts in _____
Entacapone only acts in the periphery while Tolcapone acts both in the periphery and CNS.
Anti-parkinsonism drug that is also an Anti-influenza (antiviral)
AMANTADINE - used for influenza A only
MOA: Inhibit early step replication and prevent uncoating by binding to M2 proton channels
A drug that causes LIVEDO RETICULARIS
AMANTADINE [C]
What drugs can cause livedo reticularis?
HYDROXYUREA AMANTADINE MINOCYCLINE GEMCYTABINE QUINIDINE
anti muscarinic agents used for Parkinson disease:
TRI (TRIhexiphenydyl) to PARK (drugs for PARKinsons) your BENZ (BENZtropine), BIP (BIPeriden) here.
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
TETRABENAZINE, RESERPINE
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
HALOPERIDOL, PIMOZIDE
