DA

Question 1

L-DOPA (levodopa)

Answer 1

MOA: 1. precursor of DA synthesis. 2. increases release of DA in striatum.

Side Effects : motor, GI, behavioral. also dyskinesia (DA too high)

Dosage forms: oral

interactions: nonselective MAOI, DA reuptake transporter inhibitors, and Antipsychotics
End of dose effects

Question 2

Carbidopa

Answer 2

MOA: Block breakdown of L-dopa or conversion to DA in the periphery. inhibits L-AAAD in gut and blood stream. to be administered with L-DOPA to increase amount that reaches CNS.
does not cross BBB

Question 3

Entacapone (Comtan)

Answer 3

MOA:Block breakdown of L-dopa or conversion to DA in the periphery. inhibits COMT in gut and blood stream
does not cross BBB

Question 4

Sinemet

Answer 4

carbidopa + L-DOPA

Question 5

Stalevo

Answer 5

carbidopa + L-DOPA + entacapone

Question 6

Amantadine (Symmetrel)

Answer 6

MOA: 1. stimulates DA release in synapse of SN. 2. Increases release of synaptic DA in the striatum.

Side effects : motor, GI, behavioral

ADME : renal

Interactions : drugs that increase or decrease DA activity

Dosage Forms: oral

Question 7

Selegiline (deprenyl)

Rasagiline (Azilect)

Answer 7

MOA: 1. Irreversible MAOB inhibitor. 2. increases the lifespan and concentration of synaptic DA in striatum.

Side effects: motor, GI, behavioral

ADME - hepatic

Dosage Forms: oral and transdermal

Interactions - drugs that increase or decrease DA activity, many opioids.

Question 8

Ropinirole (Requip)
Pramipexole (Mirapex)
Apomorphine (Apokyn)

Answer 8

MOA: 1. DA receptor agonist. 2. Increase activation in striatum.

Side effects - motor, GI, behavioral

ADME - hepatic (Requip, apokyn), renal (mirapex)

Dosage Forms -oral (requip, mirapex), SC (apokyn)

Interactions - drugs that increase or decrease DA activity