Drugs for Movement Disorders - Parkinson Flashcards
What is the MOA for Amantadine?
Unknown
– weak NMDA receptor antagonist
What drug can be used for the treatment of drug-induced extrapyramidal symptoms?
Amantadine
MOA-B inhibitors are used for early Parkinson Disease. Which of the 3 drugs are irreversible/reversible inhibitors?
Selegiline = irreversible
Rasagiline = irreversible
Safinamide - REVERSIBLE
Which MAO-B Inhibitor has a greater potency?
Rasagiline
Which MAO-B inhibitor has the highest selectivity?
Safinamide
What is a possible adverse effect of Selegiline?
Antidepressants increased suicidal ideation in young kid patients
Ropinirole is a ____ agonist
D2/D3
Which of the Dopamine Receptor Agonists are DA agonists?
Apomorphine
Bromocriptine
Besides Ropinirole, which of the Dopamine Receptor Agonists are also D2 Agonists?
Pramipexole
Rotigotine
Apomorphine can be given how to quickly treat “off” episodes?
Sublingual or SubQ
Which Dopamine Receptor Agonist is an ergot alkaloid derivative?
Bromocriptine
How is Rotigotine given?
24 hour transdermal patch
What are some of the unique side effects of Ropinirole?
- Increased risk of melanoma
- Orthostatic Hypotension
- Somnolence
- Headaches, N/V, constipation
Compared to some of the side effects of Ropinirole, how does Pramipexole compare?
- LESS hypotension and somnolence
- MORE hallucinations
What is a serious side effect of Tolcapone?
Fatal acute fulminant LIVER FAILURE
When should Tolcapone be used?
ONLY in patients that are on levodopa/carbidopa with symptom fluctuations and are NOT responding satisfactorily to other agents!
What is a COMT inhibitor that has a shorter half life and cannot cross the BBB?
Entacapone
What is the most potent Parkinson treatment option?
Levodopa combinations
What are some unique side effects of Levodopa + Carbidopa?
GI effects
HTN
Cardiac arrhythmias
Wearing off/ on and off phenomena
When Levodopa is given with Carbidopa, the SAME amount of Levodopa reaches the brain… so why is Carbidopa given with it?
DECREASES GI metabolism and effects by (-) DOPA Decarboxylase in the periphery to stop metabolism to Dopamine in the periphery
When should Benztropine be used?
- Tremor/dystonia in younger people
- To treat excessive drooling
In what patients should you avoid using Benztropine?
- In the elderly
- In those with cognitive impairment
This drug is used for tremors/dystonia in younger people and to treat excessive drooling
Benztropine
This drug is a DOPA Decarboxylase Inhibitor in the periphery to stop L-dopa from metabolizing to Dopamine in the periphery
Carbidopa
This drug is a COMT inhibitor in the periphery that stops L-Dopa from metabolizing to 3-OMD in the periphery
Entacapone
This drug can cause fulminant liver failure
Tolcapone
What drug can cause levido reticularis (purple skin of legs)?
Amantadine
What are some of the adverse effects seen with these drugs that are used to treat Parkinson Disease?
CNS depression Impulse control issues Psychosis Suicidal ideation Dyskinesias Orthostatic Hypotension
What are some of the adverse effects seen with these drugs that are used to treat Parkinson Disease?
CNS depression Impulse control issues Psychosis Suicidal ideation Dyskinesias Orthostatic Hypotension
The goal of Parkinson Disease treatment is to increase what molecule?
Dopamine
