CPTP 4.9-11 Flashcards
E.g. of a MAO-B inhibitor
selegiline
what is amantadine and what does it do
antiviral. stimulates release of dopamine. tx dyskinesias
difference between MAO-B inhibitors and COMT inhibitors
MAO-B inhibitors inhibit the enzyme that degrades dopamine in the neuron. COMT inhibits degredation in the synaptic cleft
e.g. of a COMT inhibitor
entacapone, tolcapone
what is a COMT inhibitor often given with (brand names)
entacapone given with sinemet (carbidopa and ldopa) to form stalevo
e.g. of dopamine agonists
rotigotine, apomorphine
Why are anticholinergics sometimes useful in PD?
In PD there is reduced dopamine and increased ACh.
When are Anticholinergics used
rarely. not in elderly ude to side effects. can use very early on in PD
anticholinergic SEs
dry mouth, constipation, dizziness, blurred vision, urine retention)
L-dopa SEs
nausea and vomiting, postural hypotension, visual hallucinations, insomnia
management of motor complications in PD tx
fractionate ldopa dose, adjuvant tx (DA, COMT-i, MAOI), duodenal ldopa, apomophine infusion, DBS
administration of DA
rotigotine patch. apomorphine SC.
DA side effects
impulse control disordesr, N/V, postural hypotension, somnolence, hallucinations
when is entacapone given
with each lpoa dose
PD tx in newly diagnosed young person
MAO-B inhibitor, dopamine agonist initially. then progress to ldopa and COMT inh
PD tx in newly diagnosed biologically frail person
ldopa. then progress to comt inh and mao-b inh