L 20 Anti Parkinsons Flashcards
What are the Anticholinergic drugs?
Benztropine
Procyclidine
Trihexyphenidyl
Diphenydramine
Trihexyphenidyl MOA?
inhibit Ach
Benzotropine MOA?
block muscarinic receptors in striatum
Procyclidine MOA?
Relieving rigidity & salivation
Adverse effects of anticholinergic drugs?
constipation
urinary retention
confusion
hallucinations
Benedryl MOA?
anticholinergic
block DA reuptake
Diphenhydramine therapeutic uses?
elderly who can’t tolerate
L-dopa
L- Dopa MOA?
precursor to DA
rapid onset– large doses needed
Combine L-Dopa with?
peripherally acting dopacarboxylase inhibitor that can’t cross BBB to prevent premature metabolism
Carbidopa
L-Dopa problems?
Requires DA neurons to make it DA
Effectiveness reduce after 2-5 yrs
On/Off effect
Parkinsons Symptoms
L-Dopa peripheral SE?
Nausea/ Vomit
Tachy
Orth. HTN
Arrythmia
Anorexia
L-Dopa central SE?
Hallucinations
Delusions
Motor Fluctuations
Dyskinesias
Vivid Dreams
Sleep Disturbance
Dangerous L-Dopa drug combinations?
MAO (-) – HTN, Stroke
Adrenomimetic amines – asthma/ emphysema tx – arrhythmia
DA agonists SE?
Stimulate DA sites directly
Long duration, less effect. than L-Dopa
Delay initiation of L-Dopa
Somnolence, Insomnia, Fatigue
Receptor desensitize – Inc symptoms
Impulse control disorder
What drugs are D2/D3 Agonists?
Pramipexole
Ropinirole
Rotigotine
COMT Inhibitor drugs?
Entacapone
Tolcapone
Entacapone MOA?
inhibits peripheral COMT
Tolcapone MOA?
inhibits peripheral & central COMT
COMT Inhibitors MOA?
(-) metabolization of DA & L-Dopa
to inactive 3-O-methyl DOPA
COMT inhibitors SE?
Athoptosis
Confusion/ Hallucinations
Possible Fatal Hepatotoxicity
What needs to be monitored for a pt on Tolcapone?
liver enzymes
MAO-B Inhibitor Drugs?
Selegiline
Rasagiline
MAO-B Inhibitor MOA?
inhibits DA metabolism
can delay L-dopa
Dont combine MAO-B inhibitor with?
tricyclic antidepressants
selective serotonin uptake inhibitors
