Movement Disorders Flashcards

1
Q

What drug agents should be used for treatment of acute EPS with dystonia and Parkinsonism?

A

Anticholenergic (benztropine) recommended
- antihistamine & anticholenergic
-Amantadine

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2
Q

What drug agents should be used for patients with acute EPS with akathisia?

A

Beta blocker (propanolol) recommended
GABA enhencer (Benzodiazepine)

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3
Q

Which drug agent is recommended in patients with Tardive Dyskinesia?

A

Amantadine

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4
Q

MOA:
Amantadine

A

DA enhancer
Non-compettive NMDA antagonists

used in early Parkinson’s for mild symptoms

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5
Q

Identify the class:

Valbenazine
Deutetrabenazine

A

VMAT2 inhibitors

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6
Q

MOA:
Valbenazine
Deurtetrabenazine

A

Decrease DA in synapses

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7
Q

Identify the class:

Levodopa
Carbidopa
Cabidopa/levodopa
Ropinirole
PRamiprexole
Rotigotine
Bromotcriptive

A

Dopaminergic

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8
Q

MOA:
Dopamine agonists drugs

A

stimulates DA receptors

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9
Q

Can carbidopa be given by itself?

A

Never.
Has no efficacy
Decreases the amount of levodopa needed for symptom relief

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10
Q

Can levodopa be given by itself?

A

Yes,
but adding cabidopa increases the therapeutic effect by allowing DA to cross the BBB

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11
Q

Adverse reaction:
Carbidopa/levodopa

A

Orthostatic HTN
dizziness
H/A
Depression
N/V

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12
Q

Bromocriptine is mainly used for what?

A

D2 receptor, but can also target D3 and D4.
Not the first choice for parkinsonisms anymore d/t less efficacy

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13
Q

Ropinirole targets mainly which receptor?

A

more selective for D2

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14
Q

Pramipexole targets which receptor?

A

D2 & D3 receptors, with specificity for D3

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15
Q

Identify Drug class:

Entacapone
Tolcapone

A

COMT inhibitors

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16
Q

MOA:
Entacapone
Tolcapone

A

Inhibits catechol-o-methyltransferase (COMT) degrades levodopa

17
Q

Can COMT inhibitors agents be used alone?

A

No, use with capidopa/levodopa.
No effects as a monothereapy

18
Q

Adverse effects:
COMT inhibitors

A

Orthostatic HTN
Drowsiness
Insomnia
N/V
Dyskinesia

19
Q

Which agent would you use for a patient with parkinson’s associated with psychosis (hallucination/delusion)?

A

Pimavanserin

20
Q

MOA:
Pimavanserin

A

inverse agonist at the 5-HT2a receptor
(decreases stimulation at 5-HT2a below basal level)