HY meds

Question 1

Levodopa

Answer 1

dopamine replacement

tx: parkinson’s

+carbidopa

Question 2

Entacapone

Answer 2

COMT inhibitor (prevents peripheral conversion of L-Dopa –> Methyldopa)

tx: parkinson’s

+levodopa/carbidopa

LIVER TOXICITY
DISCOLORED URINE

Question 3

Selegiline

Rasagiline

Answer 3

MAO-B inhibitors (prevent selective degradation of DA)

tx: parkinson’s

Question 4

pramipexole

ropinirole

Answer 4

D2 receptor agonists, non-ergots

tx: parkinson’s

COMPULSIVE BEHAVIORS

Question 5

apomorphine

Answer 5

DA agonist, super POTENT

tx: parkinson’s

subQ injection for intermittent episodes

ORTHOSTASIS

Question 6

benztropine

Answer 6

anticholinergic (anti-muscarinic)

tx: parkinson’s
- Used to rebalance DA:Ach ratio; treats tremors > rigidity

Question 7

amantadine

Answer 7

anti-viral

tx: parkinson’s (unknown MOA)

may improve rigidity, tremor and drug-related dyskinesia.

Question 8

Methylphenidate

Answer 8

amphetamine, indirect monoamine agonist

block storage/reuptake of NE/DA

tx: ADHD

Question 9

atomoxetine

Answer 9

ADHD

Selective inhibitor of NE transport (NSRI)
NONSTIMULANT

Blocks NE reuptake so it is available in synapse for longer in prefrontal cortex.

similar mech to anti-depressants.

Question 10

Guanfacine, Clonidine

Answer 10

ADHD

MOA: alpha-2 receptor agonists (sympatholytic) –> prevents release of NTs
(recall alpha-2 receptors - when stimulated - suppress release of transmitter)

(MOA for ADHD unclear)

Question 11

caffeine

Answer 11

MOA: adenosine receptor antagonist (same shape, but does not cause same effect, just blocks site)
- ultimately inhibiting an inhibitor –> inc transmitter release

Adenosine binding to PRESYNAPTIC receptor:

• closes Ca++ channels
• decreased NT release

Adenosine binding to POSTSYNAPTIC receptor:

• open K+ channel
• hyperpolarizes cell
• decreased response to stimuli

If BLOCKED:

• increased NT release
• increased response to stimuli

Question 12

Modafinil

Answer 12

tx: Sleepiness

Blocks dopamine transporter (dopamine available in synapse longer).
Increases synaptic dopamine (DSRI).
Not entirely clear how it relates to sleep

Question 13

gammahydroxybutyrate

Answer 13

tx: narcolepsy, cataplexy

-potent enhancer of GABA (powerful sedative bc GABA is primary inhibitor)
-exhibits GABA and dopamine-like effects
^ DA/GABA agonism

date rape drug (conscious sedation)

Question 14

phentermine

Answer 14

anorexiant

NE transporter inhibition

• NE stays in synapse longer, acts as stimulant
• sympathetic NS activated, parasympathetic suppressed

Question 15

lorcaserin

Answer 15

anorexiant

5HT(2C) [serotonin] receptor agonist

• more serotonin produced
• change in hypothalamus
• less hungry

-similar receptor being modulated as fen-phen –> possibly future cardiomyopathy issues?

Question 16

burpropion + Naltrexone

Answer 16

Anorexiant

DA and NE reuptake inhibitor.
Opioid receptor antagonist. (prevent reward pathways from being stimulated. No reward when people eat.)

Question 17

chlorpromazine

Answer 17

anti-psychotic

low potency older/typical agent (+sx)

D2 > 5HT2A

Question 18

haloperidol

Answer 18

anti-psychotic

high potency older/typical agent (+sx)

D2 > 5HT2A

Question 19

clozapine

Answer 19

antipsychotic

most common newer/atypical agent (-sx)

5HT2A > D2