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Pharmacology NURS 362 > Exam 1: Parkinson's (PD) > Flashcards

Exam 1: Parkinson's (PD) Flashcards

1
Q

Class: Dopamine replacement (1st line)
Drugs:

A
  • levodopa (L-dopa)

- levodopa-carbidopa (Sinemet, Parcopa)

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2
Q

Class: Dopamine replacement (1st line)
Drug: levodopa (L-dopa)
MOA:

A
  • Converted to DA in CNS
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3
Q

Class: Dopamine replacement (1st line)
Drug: levodopa (L-dopa)
Indications:

A
  • Typically 1st line of trmt (Most effective)
  • Bradykinesia
  • Tremor
  • rigidity
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4
Q

Class: Dopamine replacement (1st line)
Drug: levodopa (L-dopa)
Contraindications:

A
  • Less effective w/standing + coordination
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5
Q

Class: Dopamine replacement (1st line)
Drug: levodopa (L-dopa)
Side effects:

A
  • N/V
    **give on empty stomach
  • Orthostats
    ↑SE @ 5-10 yrs (1/2 pts)
    • On-Off effect → may improve w/ “drug holiday” ~10 days
    • Dyskinesia
    • BENEFIT VS SE
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6
Q

Class: Dopamine replacement (1st line)
Drug: levodopa (L-dopa)
Toxicity/AE:

A
  • DDS (4%)
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7
Q

Class: Dopamine replacement (1st line)
Drug: levodopa-carbidopa (Sinemet, Parcopa)
MOA:

A
  • Carbidopa combined w/several formulations of l dopa

* *C-dopa alone = no benefit

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8
Q

Class: Dopamine replacement (1st line)
Drug: levodopa-carbidopa (Sinemet, Parcopa)
Indications:

A

↓ s/s

↑efficiency

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9
Q

Class: Dopamine replacement (1st line)
Drug: levodopa-carbidopa (Sinemet, Parcopa)
Contraindications:

A
  • *over time loses benefit

- Usually by yr 5

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10
Q

Class: Dopamine replacement (1st line)
Drug: levodopa-carbidopa (Sinemet, Parcopa)
Side effects:

A
  • Confusion
  • Hallucinations - Delusions
  • Agitation
  • Psychosis
  • DDS (4%)
  • N/V
  • Fatigue
  • Dizziness
  • HA
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11
Q

Class: Dopamine replacement (1st line)
Drug: levodopa-carbidopa (Sinemet, Parcopa)
Route/dosing:

A
  1. Small doses
  2. Titrated ↑ over several weeks → ↓ SE
    - Sinemet - PO (slow-release: CR)
    - Parcopa - sublingual
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12
Q

Class: Dopamine agonist (1st line)
Drugs:

A
  • Bromocriptine (Parlodel)
  • pramipexole (Mirapex)
  • ropinirole (Requip)
  • apomorphine (Apokyn)
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13
Q

Class: Dopamine agonist (1st line)
MOA:

A
  • stimulate dopamine (DA) receptors in brain
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14
Q

Class: Dopamine agonist (1st line)
Indications:

A
  • monotherapy in early PD
    • Esp <65
    • Need to add l-dopa after a few yrs
  • combination therapy in advanced PD
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15
Q

Class: Dopamine agonist (1st line)
Contraindications:

A

**Won’t work if pts already don’t respond to l-dopa

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16
Q

Class: Dopamine agonist (1st line)

Side effects:

A
  • Sedation
  • leg swelling
  • Visual hallucinations
  • Orthostats
  • confusion
17
Q

Class: monamine oxidase B (MAO-B) inhibitors (1st line)
Drugs:

A
  • selegiline (Eldepryl)

- rasagiline (Azilect)

18
Q

Class: monamine oxidase B (MAO-B) inhibitors (1st line)
MOA:

A
  • Block enzymes that inactivate DA
19
Q

Class: monamine oxidase B (MAO-B) inhibitors (1st line)
Indications:

A

**benefit usually small if any

20
Q

Class: monamine oxidase B (MAO-B) inhibitors (1st line)

Side effects:

A
  • Nausea
  • HA
  • Difficulty falling asleep
21
Q

Class: monamine oxidase B (MAO-B) inhibitors (1st line)
Interactions:

A

Antidepressants = ↑ BP

22
Q

Class: COMT inhibitors (2nd line)
Drugs:

A
  • tolcapone (Tasmar)

- entacapone (Comtan)

23
Q

Class: COMT inhibitors (2nd line)
MOA:

A
  • ↓ catechol-O-methyl transferase
    • Usually breaks down NTs
    • ↑T1/2 l-dopa
24
Q

Class: COMT inhibitors (2nd line)
Indications:

A

↑ effectiveness l-dopa

- on-off effect

25
Q

Class: COMT inhibitors (2nd line)
Contraindications:

A

**not effective when taken alone

26
Q

Class: COMT inhibitors (2nd line)

Side effects:

A
  • Dyskinesias
  • Hallucinations - Confusion
  • n/v/d
  • Orange urine
  • Orthostats
  • *Tamsar may ↑ liver enzymes → monitor 1st yr
27
Q

Class: Dopamine releasing/antiviral
Drug:

A

amantadine (Symmetrel)

28
Q

Class: Dopamine releasing/antiviral
Drug: amantadine (Symmetrel)
MOA:

A
  • Improves S/S in advanced dx - ANTIVIRAL

- Benefit may be temporary

29
Q

Class: Dopamine releasing/antiviral
Drug: amantadine (Symmetrel)
Indications:

A
  • Combo w/l-dopa

• ↓ dyskinesia

30
Q

Class: Dopamine releasing/antiviral
Drug: amantadine (Symmetrel)
Side effects:

A
  • Visual hallucinations
  • Confusion
  • Ankle-swelling
  • Livedo reticularis (Blotchy-purple skin)
31
Q

Class: Anti-cholinergic
Drugs:

A
  • benztropine (Cogentin)

- trihexyphenidyl

32
Q

Class: Anti-cholinergic
MOA:

A
  • Blocks cholinergic receptors in brain

• Restore DA/ACh balance

33
Q

Class: Anti-cholinergic
Indications:

A
  • ↓ tremor

- <70 yo w/o significant difficulties walking

34
Q

Class: Anti-cholinergic

Side effects:

A

Hot as a hare, blind as a

bat, dry as a bone, red as a beet, mad as a hatter “can’t see, can’t pee, can’t spit, can’t shit”

Pharmacology NURS 362 (6 decks)

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