NERVOUS SYSTEM: DOPAMINERGIC DRUGS FOR PARKINSONS Flashcards

1
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: INDICATIONS

A
  • Early Parkinson’s disease
  • Later PD
  • Secondary Parkisonisml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: MOA

A
  • Def of dopamine in the NIGROSTRIATAL PATHWAY
  • Via direct and indirect circuits, this causes the basal ganglia to exert greater inhibitory effects on the thalamus which, in turn, reduces excitatory input to the motor cortex.
  • By contrast, levodopa (L-dopa) is a precursor of dopamine that can enter the brain via a membrane transporter. Ropinirole and pramipexol are relatively selective agonists for the D2 receptor, which predominates in the striatum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: ADVERSE EFFECTS

A
  • Nausea
  • Drowsiness
  • Confusion
  • Hallucinations
  • Hypotension
  • Wearing off effect
  • Dyskinesias at the beginning of dosage interval
    ON/OFF EFFECT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: WARNINGS

A
  • Elderly
  • Those with existing cognitive or psychiatric dx due to risk of causing confusion and hallucinations
  • Used cautiously in those with CVD risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: IMPORTANT INTERACTIONS

A
  • Levodopa is always given with a peripheral dopa-decarboxylase inhibitor (e.g. carbidopa) to reduce its conversion to dopamine outside the brain
  • This desirable interaction reduces nausea and lowers the dose needed for therapeutic effect.
  • Dopaminergic agents should not usually be combined with antipsychotics (particularly first-generation) or metoclopramide because their effects on dopamine receptors are contradictory.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

DOPAMINERGIC DRUGS FOR PARKINSONS: EXAMPLES

A
  • levodopa (as co-careldopa, co-beneldopa)
  • ropinirole
  • pramipexol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly