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NMSP Week 1 > Drugs for Movement Disorders (Wolff) > Flashcards

Drugs for Movement Disorders (Wolff) Flashcards

1
Q

What preferentially metabolizes norepinephrine and serotonin?

What preferentially metabolizes phenylethylamine and benzylamine?

What preferentially metabolizes dopamine and tryptamine?

A

1) MAO-A
2) MAO-B
3) Equally by MAO-A and MAO-B

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2
Q

What is amantadine?

A

Noncompetitive NMDA receptor antagonist

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3
Q

What is the clinical application for amantadine?

A

As adjunctive therapy for dyskinesia in Parkinson’s patients receiving levodopa

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4
Q

What are potential toxicities of amantadine?

A

1) CNS depression
2) Psychosis
3) Livedo reticularis (Purplish discoloration of legs)

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5
Q

What is ropinirole?

A

A D2 receptor agonist

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6
Q

D2 receptors are coupled to?

This causes?

A

1) Gi

2) Decrease cAMP

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7
Q

What is the clinical application for ropinirole?

A

Treatment of Parkinson disease

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8
Q

What are potential toxicities of ropinirole?

A

1) Dyskinesia
2) Increase risk of melanoma
3) Orthostatic hypotension

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9
Q

What is selegiline?

A

A potent irreversible inhibitor of MAO

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10
Q

What is the clinical application for selegiline?

A

Adjunct in the management of Parkinson disease

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11
Q

What is the black box warning for selegiline?

A

Increased risk of suicidal thoughts and behaviors in pediatric and young adult patients

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12
Q

What is tolcapone?

A

A selective and reversible inhibitor of COMT

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13
Q

What is the clinical application of tolcapone?

A

Adjunct to levodopa and carbidopa

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14
Q

What is the black box warning for tolcapone?

A

Risk of fatal acute fulminant liver failure

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15
Q

What effect does COMT inhibiton have?

A

More sustained plasma levels of levodopa

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16
Q

Entacapone is another nitrocatechol COMT inhibitor but differs from tolcapone in that?

A

It cannot cross the BBB

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17
Q

What is the most effective agent for treating motor symptoms of Parkinson disease?

A

Carbidopa + levodopa

18
Q

Carbidopa + levodopa crosses the BBB via?

A

L-amino acid transporter

19
Q

What does carbidopa block?

A

Peripheral DOPA decarboxylase

20
Q

Why is carbidopa given with levodopa?

A

Carbidopa prevents levodopa from being converted into dopamine prematurely in the bloodstream, allowing more of it to get to the brain

21
Q

Deep brain stimulation of what areas of the brain are effective against motor fluctuations and dyskinesia?

A

Subthalamic nucleus or globus pallidus interna

22
Q

What is the “on-off” phenomenon in Parkinson disease?

A

The back and forth switch between mobility and immobility in levodopa treated patients

23
Q

What is benztropine?

A

Cholinergic antagonist at muscarinic receptors

24
Q

What is the clinical application for benztropine?

A

Tremor and dystonia in younger Parkinson’s patients

25
Q

What populations should avoid benztropine?

A

1) Elderly

2) Cognitive impaired patients

26
Q

What Parkinson medications should be given for mild symptoms/little interference with daily function?

A

1) MAO-B inhibitor

2) Amantadine

27
Q

When should levodopa be given as initial therapy?

A

Older than 65 with symptoms affecting daily life

28
Q

What potential non-motor symptom of PD is treated with injection of botulinum toxin A into the salivary glands?

A

Sialorrhea

29
Q

What potential non-motor symptom of PD is treated with midodrine, domperidone, and fludrocortisone?

A

Orthostatic hypotension

30
Q

What potential non-motor symptom of PD is treated with melatonin or clonazepam?

A

REM sleep behavior disorder

31
Q

What potential non-motor symptom of PD often precedes motor symptoms and becomes more prominent and difficult to treat with Parkinson disease progression?

A

Depression

32
Q

What potential non-motor symptom of PD is treated with quetiapine and clozapine?

A

Psychosis

33
Q

Cholinesterase inhibitors such as rivastigmine or donepezil and/or NMDA-antagonist memantine are used to slow?

A

Dementia

34
Q

What receptor when activated in PD treatment, can cause psychosis, nausea, and vomiting?

A

D2 receptors

35
Q

What receptor when blocked in PD treatment, can cause dementia?

A

Ach muscarinic receptors

36
Q

What is the current therapy to treat/manage Huntington Disease?

A

There are no current therapies that slows disease progression

37
Q

Restless leg syndrome is a common condition that causes?

A

Uncontrollable urge to move the legs

38
Q

What pharmacologic therapy is used to treat restless leg syndrome?

A

1) Ropinirole

2) Carbidopa-levodopa

39
Q

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

A

Riluzole

40
Q

Penicillamine and potassium disulfide are agents that have what effect?

They are used with what condition?

A

1) Reduce serum copper levels

2) Wilson disease

NMSP Week 1 (13 decks)

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