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Pharmacology Mod 5 > Lecture 1 > Flashcards

Lecture 1 Flashcards

1
Q

What are the Treatments for Parkinsons Disease

A

DA Replacements
DA receptor agonists
COMT inhibitors
MAO B inhibitors
Anticholinergics
Amantadine

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2
Q

what are DA replacement medications

A

Levodopa and Carbidopa

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3
Q

what is Levadopa

A

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

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4
Q

what is Carbadopa

A

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

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5
Q

what are DA receptor agonists

A

Ropinirole
Bromocriptime
Pramprexole

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6
Q

what is Ropinirole

A

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)

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7
Q

What are COMT inhibitor medications

A

Entacapone

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8
Q

what is Entacapone

A

COMT inhibitor
secondary pathway to metabolize levodopa as well as DA and NE
prevents degradation of Levodopa
AE: dyskinesia, Nausea and Diarrhea

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9
Q

What are MAO B inhibitors

A

Selegiline
Rasagiline

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10
Q

what is Selegiline

A

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

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11
Q

What are anticholinergic medications used to treat Parkinsons

A

Trihexyphenidyl
Benztropine

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12
Q

What is Trihexyphenidyl

A

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

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13
Q

What is Amatadine

A

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

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14
Q

What are medications used for Alzheimers treatments

A

Cholinesterase inhibitors and NMDA anatgonists

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15
Q

what are cholinesterase inhibitors used to treat Alzheimers

A

Donepezil
Rivastigmine

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16
Q

what is Donepezil

A

Cholinesterase inhibitor
goal is to raise Ach levels in damaged areas of the brain
readily enters the CNS, relatively long lasting and may also increase ACh synthesis and release
metabolism through acetylcholinesterase activity - thus no major drug interactions
AE: GI disturbances (N/V/D), sleep disturbances - vivid dreams

17
Q

What is NMDA antagonist medications used to treat Alzheimers

A

Memantine

18
Q

what is Memantine

A

NMDA antagonist used to treat Alzheimers
blocks pathological activation of NMDA receptors
thought to reduce excitotoxicity
not as effective as Donepezil, but useful for patients that do not respond or cannot tolerate side effects
can be used in addition to Donepezil
AE: Dizziness, headache, constipation, confusion

19
Q

What are the symptomatic treatment of essential tremors

A

Beta Blockers
Anticonvusants

20
Q

what are the beta blockers used to treat essential tremors

A

Propranolol

21
Q

what are the anticonvulsants used to treat essential tremors

A

Primidone and Gabapentin

22
Q

What are the groups of medications used to treat seizures

A

Glutamate inhibitors and GABA protectors

23
Q

What are the subtypes of Glutamate inhibitors

A

Sodium channel blockers
Calcium channel blockers
SV2A blockers???

24
Q

What are Migraine medicatiosn

A

Sumatriptan and Ergotamine

25
Q

what is Sumatriptan

A

used for migraines
5-HT1 receptor
serotonin agonist, acting on small peripheral nerve receptors that innervate intracranial vascular
can be given SubQ, Intranasal or orally
short duration of action, elimination half life of 2 hours
AE: significant increase in BP and cardiac events, pain and pressure sensation in the chest, neck, throat and jaw
do not use for CAD patients

26
Q

What is Erotamine

A

migraine medication
all 5-HT receptors
given IV
biological activity of a vasoconstrictor
binds to several receptors acting as an agonists and causes constriction of intracranial extracerebral BV through serotonin receptors and by inhibiting trigeminal neurotransmission
AE: hepatotoxic

27
Q

What are sodium channel blocker medications used to treat epilepsy

A

Carbamazepine
Lamotrigine
Phenytoin

28
Q

What are the calcium channel blockers used to treat epilepsy

A

Ethosuximide and Pregabalin

29
Q

What are prophylactic medications used to prevent Migraines

A

Propranolol
anticonvulsants
CGRP antagonists

30
Q

what are the acute headache management medications

A

NSAIDs
Triptains
Ergots
steroids

Pharmacology Mod 5 (3 decks)

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