E1- Parkinson and Alzheimer's Flashcards
What drugs are used to increase DA levels/replacement therapy in the treatment of Parkinsons?
L-Dopa
What is the MOA of L-Dopa?
L-DOPA readily crosses BBB and is converted into DA in the neuron
What are the uses of L-Dopa?
1st line for PD
Improves PD sx for 3-4yrs Bradykinesia
What is L-Dopa not effective against?
Disease progression
Drug-induced Parkinsonism
What can be added to L-Dopa to decrease the dose needed and the peripheral effects?
Carbidopa
What is the MOA of Carbidopa?
Carbidopa inhibits dopa-decarboxylate, but doesn’t cross the BBB
What are SE of L-Dopa?
Nausea/emesis
Dyskinesias
Depression, anxiety, agitation, sleep problems
Psychosis
What should you give to psychosis associated with Parkinson’s?
Atypical antipsychotic
Pimavanserin (inverse agonist/5-HT receptor antagonist)
What can be used as an on-off phenomenon rescue?
Apomorphine
What are possible drug interactions with L-Dopa?
MAO-AIs (HTN crisis)
Pyridoxine (vit B6)
What is the MOA of Selegiline, Rasagiline, and Safinaminde?
Inhibit MAO-B in CNS and reduces striatal metabolism of DA
What are SE of Selegiline, Rasagiline, and Safinaminde?
Insomnia (take in morning)
Increase SE of L-Dopa in late stages of disease
What are possible drug interactions of Selegiline, Rasagiline, and Safinaminde?
MAOI (HTN crisis)
Meperidine
TCAs/SSRIs (serotonin syndrome)
What is the MOA of Tolcapone?
Inhibits COMT in CNS and periphery
What is a SE of Tolcapone and Entacapone?
Orange color urine