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Neuro II - Final Exam > Drugs For Movement Disorders - 8/23 Kruse > Flashcards

Drugs For Movement Disorders - 8/23 Kruse Flashcards

1
Q

What Sx do mAChR antagonists improve in PD?

A

Tremor

Rigidity

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2
Q

What are the Dopamine agonists and their receptors?

A 
A Real Blood Pressure
A - Apomorphine D2
R - Ropinrole D2
B - Bromocriptine D2
P - Pramipexole D3
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3
Q

What are the dopamine receptor agonists?

A

Bromocriptine
Pramipexole
Ropinirole

BRP 232

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4
Q

What 3 drugs that are kind of similar can also treat Wilson’s?

A

Trientine
Zinc acetate
Zinc sulfate (inc fecal excretion)

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5
Q

What are the only FDA approved drugs for tx of RLS?

A

Pramipexole

Ropinirole

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6
Q

What dug reduces intestinal absorption of copper and can also be used to treat Wilson’s?

A

Potassium disulfide

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7
Q

What adverse side effects does L-dopa have on the CV system?

A

Postural hypotension
HTN when taken w/MAO inhibtor or sympathomimetics
INC in cardiac arrhythmia (rare)

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8
Q

What Beta-1 antagonists are useful in treating tremors?

A

Metoprolol

Propranolol

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9
Q

What COMT inhibitor may cause an increase in liver enzymes and lead to acute hepatic failure?

A

Tolcapone

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10
Q

What neurologic antipsychotic is used to treat tics?

A

Pimozide

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11
Q

What may provide patients suffering from on-off phenomenon with temp benefit?

A

Apomorphine

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12
Q

What are the COMT inhibitors?

Which one works in the CNS and PNS?

A

Tolcapone
Entacapone

Tolcapone

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13
Q

When is selegiline contraindicated?

A

When taken w/meperidine, tricyclics, SSRIs

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14
Q

Which dopamine agonist is a D2 and has extensive first-pass metabolism (CYP1A2)?

A

Ropinirole

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15
Q

What drug may cause livedo reticularis?

A

Amantadine

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16
Q

What are the adverse CV effects of dopamine agonists?

A

Postural hypotension, peripheral edema, cardiac arrhythmia

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17
Q

Adverse effects of Penicillamine?

A

Nausea, vomiting, nephritic syndrome, myasthenia, optic shit

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18
Q

Which dopamine agonist is a D2 and has extensive first-pass metabolism (CYP3A4)?

A

Bromocriptine

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19
Q

What antiviral agent whose MOA is unknown and is used to treat PD?

Use caution when?

A

Amantadine

Pts w/hx of seizure or heart failure

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20
Q

What does ACh do to GABA?

A

Excites it

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21
Q

L-dopa is contradicted in what Pts?

A

Psychotic
Angle-closure glaucoma
Melanoma Pts
Active peptic ulcer

22
Q

What chelating agent forms a stable complex to be excreted in the urine and is used to treat Wilson’s disease

A

Penicillamine

23
Q

What is Apomorphine and how does it act?

Used for what?

Adverse side effect of nausea can be pre-treated how?

A

D2 dopamine agonist

Injected sq for off-period Akinesia

Trimethobenzamide

24
Q

Where is GABA made?

A

Corpus Striatum (Caudate and Putamen)

25
Q

What do dopaminergic neurons come from?

What do they do to GABA?

A

SNpc

Inhibit

26
Q

What dopamine agonist is contraindicated in Pts with peripheral vascular disease?

A

Bromocriptine

27
Q

MOA of L-dopa?

How does it enter the CNS and does it cross the BB barrier?

A

D2 receptor (some D1 and D3)

Via LAT, YES

28
Q

Rasagiline MOA?

Used for what?

Contraindication?

A

Irreversible inhibitor of MAO-B

Neuroprotective for PD

When used with L-dopa leads to HTN crisis

29
Q

What drugs are used to treat HD?

Which one is irreversible?

A

Reserpine and tetrabenazine

Reserpine

30
Q

Which dopamine agonist is a D3 and 90% of it is excreted in the urine unchanged?

A

Pramipexole

31
Q

What are the contraindications of dopamine agonists?

A

Psychosis
MI
Peptic ulcer

32
Q

What adverse side effects does L-dopa have on movement?

A

Dyskinesia (80%)

33
Q

What are the mAChR antagonists used to treat PD?

A

Please Try BOB

Procyclidine
Trihexyphenidyl
Benztropine
Orphenadrine
Biperiden
34
Q

Patients taking L-dopa combined with what other drug may experience HTN crisis?

A

MAO A inhibitors

35
Q

What adverse side effects does L-dopa have on the GI system?

What about when administered w/de carboxylase inhibitor?

A

Anorexia, nausea, vomiting in 80%

Same but only 20% of Pts

36
Q

MAO-B preferentially metabolizes what?

A

Phenylethylamine

Benzoyl amine

37
Q

What are the non-GI or CV adverse effects of dopamine agonists?

A

Dyskinesia
Mental disturbance
Random - headache, sleepiness

38
Q

What alpha adrenergics are used to treat tics?

A

Clonidine

Guanfacine

39
Q

What preferentially metabolizes NE and serotonin?

A

MAO-A

40
Q

What is metabolized equally by MAO-A and MAO-B?

A

Dopamine

Tryptamine

41
Q

L-dopa administered with carbidopa reduceds the daily requirement of L-dopa by how much?

A

75%

42
Q

What dopamine agonist is used to treat restless leg syndrome?

A

Pramipexole

Ropinirole

43
Q

What is a selective MAO-B inhibitor?

MOA?

A

Selegiline

Slows breakdown of dopamine and prolongs the anti parkinsonian effects of L-dopa

44
Q

How do drugs that treat HD work?

A

Impair dopaminergic neurotransmission (alleviate chorea)

45
Q

What are the side effects of COMT inhibitors?

A

Orange pee
Diarrhea
Ab pain
Fucked up slee

46
Q

What are the adverse GI effects of dopamine agonists?

A

Anorexia, nausea, vomiting, constipation, dyspepsia, reflux

47
Q

How much L-dopa gets absorbed into the brain alone?

With carbidopa?

A

1-3%

10%

48
Q

What drug only effective in treating depression?

A

Carbamazepine

49
Q

What is the only drug to have an impact on survival in ALS Pts?

MOA?

Adverse side effects?

A

Riluzole

Inhibits Glutamate and blocks NMDA and kainite receptors

Nausea and weakness

50
Q

What adverse side effects does L-dopa have on behavior?

What else?

A

All kinds of crazy shit, depression, anxiety, insomnia, etc

On-off phenomenon

51
Q

What drug is used to treat depression and irritability in HD?

A

Fluoxetine

Neuro II - Final Exam (4 decks)

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