E1- Parkinson and Alzheimer's Flashcards

1
Q

What drugs are used to increase DA levels/replacement therapy in the treatment of Parkinsons?

A

L-Dopa

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2
Q

What is the MOA of L-Dopa?

A

L-DOPA readily crosses BBB and is converted into DA in the neuron

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3
Q

What are the uses of L-Dopa?

A

1st line for PD

Improves PD sx for 3-4yrs Bradykinesia

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4
Q

What is L-Dopa not effective against?

A

Disease progression

Drug-induced Parkinsonism

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5
Q

What can be added to L-Dopa to decrease the dose needed and the peripheral effects?

A

Carbidopa

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6
Q

What is the MOA of Carbidopa?

A

Carbidopa inhibits dopa-decarboxylate, but doesn’t cross the BBB

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7
Q

What are SE of L-Dopa?

A

Nausea/emesis
Dyskinesias
Depression, anxiety, agitation, sleep problems
Psychosis

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8
Q

What should you give to psychosis associated with Parkinson’s?

A

Atypical antipsychotic

Pimavanserin (inverse agonist/5-HT receptor antagonist)

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9
Q

What can be used as an on-off phenomenon rescue?

A

Apomorphine

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10
Q

What are possible drug interactions with L-Dopa?

A

MAO-AIs (HTN crisis)

Pyridoxine (vit B6)

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11
Q

What is the MOA of Selegiline, Rasagiline, and Safinaminde?

A

Inhibit MAO-B in CNS and reduces striatal metabolism of DA

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12
Q

What are SE of Selegiline, Rasagiline, and Safinaminde?

A

Insomnia (take in morning)

Increase SE of L-Dopa in late stages of disease

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13
Q

What are possible drug interactions of Selegiline, Rasagiline, and Safinaminde?

A

MAOI (HTN crisis)
Meperidine
TCAs/SSRIs (serotonin syndrome)

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14
Q

What is the MOA of Tolcapone?

A

Inhibits COMT in CNS and periphery

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15
Q

What is a SE of Tolcapone and Entacapone?

A

Orange color urine

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16
Q

What is the MOA of Entacapone?

A

Inhibits COMT in periphery only

17
Q

What drugs are DA receptor agonist used in the tx of Parkinson’s? (4)

A

Ropinirole, Pramipexole
Bromocriptine
Apomorphine

18
Q

What type of drugs continue to be effective in the tx of Parkinsons as the disease progresses?

A

DA receptor agonist

19
Q

Which drug can cause erythromelalgia (painful, itchy, swollen, red hands/feet)?

A

Bromocriptine

20
Q

What is a SE of Apomorphine? How do you treat it?

A

Nausea

Take antiemetic prior (Trimethobenzamide)

21
Q

What is DOC for restless leg syndrome?

A

Ropinirole

22
Q

Which drug can cause Livedo reticularis (reddish/blue spotting of skin)?

A

Amantadine

23
Q

Which anticholinergics are used in the tx of Parkinson’s?

A

Benztropine

Trihexyphenidyl

24
Q

What cholinesterase inhibitors are used in the tx of Alzheimer’s?

A

Donepezil, Rivastigmine, Galantamine

25
Q

What NMDA receptor antagonist is used in the tx of Alzheimer’s?

A

Memantine

26
Q

What should you NOT combine Memantine with?

A

Meperidine