Dopaminergic Drugs

Question 1

Carbidopa

Answer 1

Given with Levodopa

Turns off conversion of DA outside the brain

Question 2

MAO-B inhibitors

Answer 2

Decreases the metabolism of DA, works in the brain. Blocks the breakdown of levodopa and DA, specific for DA

Insomnia, dyskinesia, hypotension
Doesn’t work well on its own- paired with levodopa

*hypertensive Crisis, serotonin syndrome

Question 3

COMT’s

Answer 3

Inhibitor, decreases the metabolism of DA and Levodopa, works in the brain- augments ldopa available
Doesn’t work on own- paired with levodopa

Delayed Onset diarrhea (after 2wk)

Question 4

Levodopa

Answer 4

Transpired to the CNS and converted to DA and bind to D1 and D2 receptors
Given with carbidopa
Used at a later stage when symptoms are high, choice after using DRA

Dyskinesia in 80% of patients
Wearing off
N/V, orthostatic hypotension
Psychosis, sedation, ICD

Melanoma risk

Question 5

Dopamine receptor agonists

Answer 5

Used with young patients at early stage (first choice)
Act like DA but don’t get converted-activate receptors to produce response
Less effective on movement disorders
Not as effective as levodopa

Low dyskinesia
*hallucinations, sleepiness, orthostasis (older patients)
N/V, syncope
Pretreat with antiemetic

• avoid 5-HT3 agonists or promethazine

Question 6

Bromocriptine

Answer 6

DRA

Ergot derivative

Question 7

Cabergoline

Answer 7

DRA

Ergot derivative

Question 8

Pramipexole

Answer 8

DRA

Non-ergot derivative

Question 9

Ropinrole (requip)

Answer 9

DRA

Non- ergot derivative

Question 10

Apomorphine

Answer 10

DRA

Non-ergo derivative

Question 11

Amantadine

Answer 11

Other DA drug
Smooths out effects of levodopa ( less dyskinesia)
Elimination very sensitive to renal function
Began as antiviral drug

• confusion, dizzy, dry mouth, hallucinations
• livedo reticularis: rash on lower extremity

Question 12

Anti cholinergic Agents

• Benztropine
• Triexyphenidyl

Answer 12

Other DA drug
Block acetylcholine at muscarnic receptors
Effective on tremors and rigidity
Corrects imbalance of DA as receptors die off

• turns off other functions: peripheral anti muscarnic effects, drowsiness confusion delusions memory problems

Question 13

Levodopa
Carbidopa
MAO-B inhibitors
COMT

Answer 13

Dopamine Agonists

Question 14

Bromocriptine 
Cabergoline 
Ropinrole 
Apomorphine 
Pramipexole

Answer 14

Dopamine Receptor Agonists