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Neuro II Exam 2 > Drugs for Movement Disorders - Kinder > Flashcards

Drugs for Movement Disorders - Kinder Flashcards

1
Q

sinemet

A

levodopa/carbidopa

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2
Q

bromocriptine

A

ergot DA agonist

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3
Q

pramipexole

A

non-ergot DA agonist

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4
Q

rasagaline

A

monoamine oxidase inhibitor

-MAOI

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5
Q

entacapone

A

catechol-O-methyltransferase inhibitor

-COMT

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6
Q

benzotropine

A

antimuscarinic agent

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7
Q

athetosis

A

slow/writhing movement

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8
Q

dystonia

A

sustained athetosis

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9
Q

rigidity, postural instability, bradykinesia, tremor

A

parkinsons disease

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10
Q

path of PD

A

loss of dopaminergic neurons in substantia nigra

  • disinhibition of GABA neurons
  • that normally inhibit corpus striatum output
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11
Q

levodopa

A

precursor to DA - crosses BBB

via - L-amino acid transporter

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12
Q

levodopa MOA

A

stimlate D2 receptors

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13
Q

carbidopa

A

dopa decarboxsylase inhibitor
-reduces peripheral metabolism of levodopa

more to CNS

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14
Q

levodopa ADR

A

anorexia, N/V - without carbidopa

with carbidopa <20%

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15
Q

other levodopa ADR

A

postural hypotension
depressin, anxiety, agitatition
dyskinesia

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16
Q

dyskinesia and levodopa

A

80% >10yr treatment

-choreathetosis of face and distal extremities

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17
Q

wearing off phenomenon

A

end of dose akinesia

rigid and akinetic at end of dosing interval

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18
Q

on-off phenomenon

A

unrelated to tx timing

off periods of akinesia over cours eof ew hours

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19
Q

vitamin B6

A

pyridoxine

-increase peripheral metabolism of levodopa

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20
Q

levodopa CI

A

angle closure glaucoma - mydriasis

psychosis
PUD
malignant melanoma (melanin precursor)

21
Q

DA agonist MOA

A

act on postsynaptic DA receptors

22
Q

1st line for parkinsons

A

dopamine agonist

-no long term changes that happen with levodopa

23
Q

ergot alkaloid derivative D2 agonist

A

bromocriptine

24
Q

D3 agonist

A

pramipexole

25
Q

two types of MAOIs

A

MAO A - metabolize NE, serotonin, DA

MAO B - metabolize DA selectively

26
Q

rasagiline MOA

A

MAO-B - potent

27
Q

rasagiline DDI

A

avoid admin of levodopa with nonselective MAO inhibitor

-hypertensive crisis

28
Q

entacapone MOA

A

inhibit dopa dexarboxylase (carbidopa) - associated with compensatory activation of other pathways - especially COMT

-increased levels of 3O methyldopa

prolongs action of levodopa

29
Q

orange discoloration of urine

A

entacapone

30
Q

benztropine mesylate

A

anti-muscarinic agent

central acting - mAChR antagonist

31
Q

therapy of benztropine mesylate

A

improve tremor/rigidity of parkinsonism

32
Q

tx of tremors

A

respond to beta-1 receptor blockers - propranolol and metoprolol

33
Q

huntington disease

A

auto dom - chromosome 4

chorea and dementia

34
Q

exacerbation of chorea in huntingtons

35
Q

restless leg syndrome

A

associated with iron deficient anemia

36
Q

wilsons disease

A

decreased ceruloplasmin - reduced serum copper

tx - penicillamine and potassium disulfide

37
Q

tx PD

A

increase DA, decrase ACh

38
Q

nausea and vomiting with levodopa

A

D2 receptors - chemoreceptor trigger zone

39
Q

lower dyskinesia threshold

A

for long term tx of PD

40
Q

hepatotoxic

A

with tolcapone

so use IV drug - apomorphine

41
Q

DA agonist vs. levodopa

A

levodopa - more side effects, more effective

DA agonist - less side effects, not as effective

42
Q

older PD patient (>65yo)

43
Q

younger PD patient (<65yo)

A

DA agonist

44
Q

mottled skin purple, tx of PD

A

adverse of amantidine - levido reticularis

45
Q

trihexphenidyl

A

anti-muscarinic - correct DA/ACh imbalance

in younger patients

46
Q

COMI location

A

decreased peripheral metabolism

47
Q

MAOI location

A

decrased central metabolism

48
Q

tx of restless leg syndrome

A

no haloperidol

49
Q

haloperidol

A

GABA-A - used for tx of huntingtons

Neuro II Exam 2 (20 decks)

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