Lecture 1 Flashcards
What are the Treatments for Parkinsons Disease
DA Replacements
DA receptor agonists
COMT inhibitors
MAO B inhibitors
Anticholinergics
Amantadine
what are DA replacement medications
Levodopa and Carbidopa
what is Levadopa
DA replacement medication
Crosses BBB
taken up into neurons and converted by DA decarboxylase to Dopamine
Extremely effective in early treatment - over time may develop motor fluctuation
AE: dyskinesia, hallucinations/confusion and Nausea, hypotension and arrythmias
what is Carbadopa
peripheral inhibitor of L-dopa
prevents conversion to DA in periphery
does not cross BBB
reduces peripheral side effects and allows for more drug to reach the brain
what are DA receptor agonists
Ropinirole
Bromocriptime
Pramprexole
what is Ropinirole
D2, D3, D4 receptor agonist
useful in treatment of Parkinsons and restless leg syndrome
metabolized by CYP450
AE: drug interactions, less risk of cardiac valve fibrosis, D3 agonism is linked to increased risky behavior (gambling/hyper-sexuality)
What are COMT inhibitor medications
Entacapone
what is Entacapone
COMT inhibitor
secondary pathway to metabolize levodopa as well as DA and NE
prevents degradation of Levodopa
AE: dyskinesia, Nausea and Diarrhea
What are MAO B inhibitors
Selegiline
Rasagiline
what is Selegiline
MAO B inhibitor
prevents metabolism of DA
selective for Straitum, mild effect
reduces dose of Levodopa needed
Metabolized in liver by CYP450
AE: ampetamine like side effects, Seratonin syndrome
What are anticholinergic medications used to treat Parkinsons
Trihexyphenidyl
Benztropine
What is Trihexyphenidyl
anticholinergic
effective at reducing dyskinetic movements and spastic contractions
often used in combo with DA drugs
AE: anticholinergic side effects: sedation, confusion, constipation, urinary retention, HTN tachycardia
pharmacokinetics: excreted unchanged
What is Amatadine
Treatment for Parkinsons
Anti-viral medication
increases DA release and blocking NMDA reuptake
used in akinetic crisis
less effective than L-dopa
AE: may cause confusion/psychosis
What are medications used for Alzheimers treatments
Cholinesterase inhibitors and NMDA anatgonists
what are cholinesterase inhibitors used to treat Alzheimers
Donepezil
Rivastigmine