Dementia/Dopamine Drugs

Question 1

early issue in huntingtons is what in the basal ganglia?

Answer 1

increased dopamine

Question 2

name the three huntingtons drugs

Answer 2

aripiprazle
risperidone
tetrabenazine

Question 3

what is the MoA of tetrabenazine?

Answer 3

inhibit dopamine transport into vesicles of pre synaptic neurons

Question 4

what is the MoA of aripiprazole?

Answer 4

compete with dopamine for binding to dopamine receptors in BG

Question 5

what is aripiprazoles usual class of med?

Answer 5

2nd gen antipsychotic

Question 6

what are the off target receptors that aripiprazole can affect?

Answer 6

serotonin, Ach, NE, histamine

Question 7

what is aripiprazoles toxicity with serotonin?

Answer 7

metabolic syndrome

Question 8

what is aripiprazoles toxicity with Ach?

Answer 8

constipation, xerostomia, urinary retention, blurred vision

Question 9

what is aripiprazoles toxicity with NE?

Answer 9

orthostatic hypotension

Question 10

what is aripiprazoles toxicity with histamine?

Answer 10

sedation

Question 11

what is levodopa used for rx of?

Answer 11

parkinsons

Question 12

what is the MoA of levodopa?

Answer 12

precursor to dopamine and is converted into it and substitutes for loss of dopamine

Question 13

what is unique about levodopa that allows it to work?

Answer 13

can cross BBB

Question 14

can dopamine cross the BBB?

Answer 14

no

Question 15

what is molecule that turns levodopa into dopamine in periphery?

Answer 15

Dopa decarboxylase

Question 16

what is the MoA of carbidopa?

Answer 16

it blocks the action of dopa decarboxylasse to prevent levodopa from becoming dopamine before crossing the BBB

Question 17

what is the MoA of entacapone?

Answer 17

blocks COMT to help inhibit levodopa from being converted into dopamine in the periphery

Question 18

name the two drugs given in addition ot levodopa to help it be more effective

Answer 18

entacapone

carbidopa

Question 19

how long until levodopa wears off?

Answer 19

5-10 years

Question 20

what are short term toxicities of levodopa?

Answer 20

nausea/vomiting
orthostatic hypotension
psychosis

Question 21

what class of drugs does can levodopa interact with?

Answer 21

MAOs

Question 22

name the two dopamine agonists used in parkinsons

Answer 22

bromocriptine

pramiprexole

Question 23

what is the MoA of bromocriptine and pramiprexole?

Answer 23

act as dopamine agonists in the substantia nigra

Question 24

what is toxicity of bromocriptine and pramiprexole?

Answer 24

suppression of prolactin secretion in tuberoinfundibular pathway

Question 25

what is cardio tox of bromocriptine?

Answer 25

cardiac valve fibrosis

Question 26

what is psych effect of pramiprexole?

Answer 26

sedation...somnolence

Question 27

what class of antidepressants can be used to treat parkinsons?

Answer 27

MAOB inhibitors

Question 28

name the two monoamine oxidase B inhibitors used in parkinsons

Answer 28

selegiline | rasagiline

Question 29

how do MAOB inhibitors work in dopamine pathways?

Answer 29

block breakdown of dopamine in neurons and increase release

Question 30

what is the dopamine release stimulator used in parkinson rx?

Answer 30

amantadine

Question 31

what is MoA of amantadine?

Answer 31

stimulates release of dopamine

Question 32

name two tox of amantadine?

Answer 32

dizziness and insomnia

Question 33

what is the anticholinergic used in parkinson rx?

Answer 33

benztropine

Question 34

explain why an antichilinergic works in parkinson rx?

Answer 34

because Ach fires to counteract normal action of dopamine so you take away the counteracting firing and it helps increase the level of dopamine firing

Question 35

name the toxicities of benztropine in parkinson rx?

Answer 35

xerostomia tachycardia constipation urinary retention

Question 36

for mild symptoms of parkinsons, what meds are considerd?

Answer 36

MAO Amantadine anticholinergic

Question 37

for moderate symptoms of parkinson what meds are considered?

Answer 37

levodopa or DA agonist

Question 38

for severe symptoms of parkinsons, what meds are considered?

Answer 38

levodopa plus DA agonist or MAO

Question 39

what mechanism of action treats cognitive issues in dementia?

Answer 39

cholinesterase inhibitors are used

Question 40

name the three cholinesterase inhibitors

Answer 40

donepezil galantamine rivastigmine

Question 41

what meds are used to treat alzheimers and lewy body dementia?

Answer 41

donepezil galantamine rivastigmine

Question 42

cholinesterase inhibitors lead to what issue in ANS?

Answer 42

increased cholinergic effects

Question 43

what are symptoms associated with donepezil galantamine rivastigmine ?

Answer 43

isnomnia vivid dreams bradycardia syncope

Question 44

in addition to donepezil galantamine rivastigmine, what other drug is used to treat alzheimers?

Answer 44

memantine

Question 45

what is MoA of memantine?

Answer 45

inhibits neuron death caused by extrasynaptic glutamate receptors that usually induce neuron death