Drugs for neurodegenerative disorders Flashcards
CV side effects of levodopa
Cardiac arrhythmias
Postural hypotension
Drug interactions of levodopa
Pyridoxine/Vit B6
MAO-A inhibitors
Contraindications of levodopa
Psychotic pts
Angle-closure glaucoma
Effective drug class choice in on-off phenomenon from levodopa
Dopaminergic agonists
Dopaminergic agonists that act on D2 receptors only
Bromocriptine
Ropinirole
Dopaminergic agonists that act on D3 receptors
Pramipexole
Rotigotine
Dopaminergic agonist that acts on both D1 and D2 receptors
Pergolide
GI side effect of dopaminergic agents
Anorexia
N/V
Reflux esophagitis
Bleeding from peptic ulcer
CV side effects of dopaminergic agents
Postural hypotension
Painless digital vasospasm
Peripheral edema
Types of MAO-B inhibitors used to treat Parkinson’s
Selegiline
Rasagiline
Adjuvant therapy for pts with a declining or fluctuating response to levodopa that enhances or prolongs the effect to levodopa
MAO-B inhibitor
Drug interaction of MAO-B inhibitors
May cause serotonin syndrome if taken with meperidine
COMT inhibitor that acts peripherally
Entacapone
COMT inhibitor that acts centrally
Tolcapone
Drug class that acts by diminishing the metabolism of levodopa, thereby increasing its availability
COMT inhibitors
Specific side effect to monitor with tolcapone
Increase in LFTs, rarely associated with acute hepatic failure
Potent D2 dopamine agonist
Apomorphine
Drug used for the temporary relief of off-periods of akinesia in pts on dopaminergic therapy
Apomorphine
Specific side effect of apomorphine
Troublesome nausea, especially at initiation
Antiviral agent that may potentiate dopaminergic function
Amantadine
Skin side effect of amantadine
Livedo reticularis
Central anticholinergics used in Parkinson’s
Trihexyphenidyl
Procyclidine
Biperiden
Drug classes that improves the tremor and rigidity of parkinsonism, but has little effect on bradykinesia
Central anticholinergics
Antimuscarinic agent (benztropine)
Drug that acts as antagonist at M receptors in basal ganglia
Benztropine
Typical antimuscarinic effects
Sedation
Mydriasis
Urinary retention
Constipation
Confusion
Dry mouth
Agents that can cause drug-induced parkinsonism
Reserpine
Tetrabenazine
Haloperidol
Metoclopramide
MPTP
Treatment options for non-parkinson movement disroders
Beta blockers
Drugs potentiating GABA-a receptors in CNS
Drugs that potentiate GABA-a receptors in CNS
Topiramate
Primidone
Benzodiazepines
Drugs that act by depleting dopamine from nerve endings, used in Huntington’s disease
Tetrabenazine
Deutetrabenazine
Reserpine
Drugs that act as dopamine receptor blockers, used in Huntington’s disease
Haloperidol
Fluphenazine
Drugs that block central D2 receptors, used in tic disorders
Pimozide
Haloperidol
Fluphenazine
Alpha-2 adrenergic agonists used in Tourettes and ADHD
Guanfacine
Clonidine
Drug class/type used in restless leg syndrome
Dopamine agonists
Gabapentin
Drug classes used in treatment of Alzheimer’s disease
Acetylcholinesterase inhibitors
NMDA receptor antagonist
Inhibitors of microtubule disassembly
Types of acetylcholinesterase inhibitors, used in Alzheimer’s
Donepezil
Rivastigmine
Galantamine
Tacrine
NMDA receptor antagonist
Memantine
Mechanism of memantine
Decreases IC Ca accumulation, aiding in prevention of excitotoxic neuronal damage
Inhibits glutamate excitotoxicity that damages neurons
Inhibitor of microtubule disassembly in Alzheimer’s
Epothilone-D
Drug used for ALS
Riluzole
Mechanism of riluzole
reduces presynaptic glutamate release