Movement Disorders Flashcards
What drug agents should be used for treatment of acute EPS with dystonia and Parkinsonism?
Anticholenergic (benztropine) recommended
- antihistamine & anticholenergic
-Amantadine
What drug agents should be used for patients with acute EPS with akathisia?
Beta blocker (propanolol) recommended
GABA enhencer (Benzodiazepine)
Which drug agent is recommended in patients with Tardive Dyskinesia?
Amantadine
MOA:
Amantadine
DA enhancer
Non-compettive NMDA antagonists
used in early Parkinson’s for mild symptoms
Identify the class:
Valbenazine
Deutetrabenazine
VMAT2 inhibitors
MOA:
Valbenazine
Deurtetrabenazine
Decrease DA in synapses
Identify the class:
Levodopa
Carbidopa
Cabidopa/levodopa
Ropinirole
PRamiprexole
Rotigotine
Bromotcriptive
Dopaminergic
MOA:
Dopamine agonists drugs
stimulates DA receptors
Can carbidopa be given by itself?
Never.
Has no efficacy
Decreases the amount of levodopa needed for symptom relief
Can levodopa be given by itself?
Yes,
but adding cabidopa increases the therapeutic effect by allowing DA to cross the BBB
Adverse reaction:
Carbidopa/levodopa
Orthostatic HTN
dizziness
H/A
Depression
N/V
Bromocriptine is mainly used for what?
D2 receptor, but can also target D3 and D4.
Not the first choice for parkinsonisms anymore d/t less efficacy
Ropinirole targets mainly which receptor?
more selective for D2
Pramipexole targets which receptor?
D2 & D3 receptors, with specificity for D3
Identify Drug class:
Entacapone
Tolcapone
COMT inhibitors
MOA:
Entacapone
Tolcapone
Inhibits catechol-o-methyltransferase (COMT) degrades levodopa
Can COMT inhibitors agents be used alone?
No, use with capidopa/levodopa.
No effects as a monothereapy
Adverse effects:
COMT inhibitors
Orthostatic HTN
Drowsiness
Insomnia
N/V
Dyskinesia
Which agent would you use for a patient with parkinson’s associated with psychosis (hallucination/delusion)?
Pimavanserin
MOA:
Pimavanserin
inverse agonist at the 5-HT2a receptor
(decreases stimulation at 5-HT2a below basal level)
