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New Mix > Neurodegenerative Disease > Flashcards

Neurodegenerative Disease Flashcards

1
Q

Riluzole

A

ALS; complex pre and post synaptic mechanism: inhibits GLU release, inhibits NMDA and kainite GLU receptors; inhibits fast Na+ channels (slight effect to slow disease progression 2-3 months)

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2
Q

Edaravone

A

ALS; mechanism unclear, no benefit advanced cases, may slow in early disease, IV dosing

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3
Q

Baclofen

A

GABAb agnoist - acts in spinal cord inhibit motoneurons (palliative ALS); skeletal muscle relaxant

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4
Q

Tizansidine

A

alpha2 agonist; CNS to decrease muscle tone palliative ALS also skeletal muscle relaxant

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5
Q

Dextromethorphan

A

Pseudobulbar affect in ALS; complex MOA: agnoist at sigma receptor, weak inhibition of 5-HT transporter; allosteric inhibition of NMDA

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6
Q

Quinidine

A

reduced dextromethorphan metablism so acts longer (by CYP2D6)

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7
Q

L-DOPA/Carbidopa

A

LDOPA DA precursor enters CNS via AA transporter (neutral), enters DA neurons, converted to DA by DOPA decarboxylase (nausea, vomiting); Carbidopa does not penetrate CNS, keeps L DOPA from converting to DA in periphery

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8
Q

DA Receptor Agonists

A

Parkinson’s less motor recovery and more side effects than L DOPA but less risk of dyskinesias (nausea, vomiting, psychiatric rxns, postural hypotension)

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9
Q

Bromocriptine

A

obsolete ergot DA receptor agonist

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10
Q

Pramipexole

A

renal clearance; non ergot DA receptor agonist also approved for sudden restless leg syndrome. D2 agonists can impair impulse control, lead to excessive gambling, shopping, food intake, sexual activity etc

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11
Q

Ropinirole

A

hepatic clearance; non ergot DA receptor agonists; can impair impulse control

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12
Q

Rotigitine

A

24 hr transdermal patch DA receptor agonist

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13
Q

apomorphine

A

non ergot DA receptor agonist injected s.c. rapid but temp relief of off akinesia episodes; nausea common

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14
Q

trimethobenzamide

A

pretreat nausea of apomorphine, antiemetic

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15
Q

MAO-B inhibitors

A

minor effects for Parkinson’s alone but enhance L DOPA effects

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16
Q

Selegiline

A

MAO B inhibitor; metabolites include methaphetamine and amphetamine - insomnia anxiety. minor effects for Parkinson’s alone but enhance L DOPA effects

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17
Q

Rasagline

A

MAO B inhibitor; minor effects for Parkinson’s alone but enhance L DOPA effects

18
Q

COM-T inhibitors

A

peripheral action only, enhances L DOPA by blocking converstion to 3-O methylDOPA

19
Q

Entacapone

A

COM-T inhibitor peripheral action only, enhances L DOPA by blocking converstion to 3-O methylDOPA

20
Q

antimuscarnics

A

parkinsons - improve tremor and rigidity, little effect on bradykineseia (poorly tolerated effects in eldery)

21
Q

benztropine

A

antimuscarinic improve tremor and rigidity

22
Q

trihexiphenidyl

A

antimuscarinic - improve tremor and rigidity

23
Q

diphenhydramime

A

antimuscaranic - improve tremor and rigidity

24
Q

Amantidine

A

enhances DA release but short-lived (weeks to months) improves most aspects of motor control for this time; unique ability to decrease L DOPA induced dyskinesias

25
Q

Stalevo

A

combination of entacopone (COMT inhibitor) LDOPA and Carbidopa helpful in severe disease with on-off fluctuations

26
Q

Safinamide

A

New MAO B inhibitor for decreasing off episodes in late stage Parkinsons. Also has effects to block Na+ channels and reduce Glutamate release

27
Q

Pimavaserin

A

new 5HT2A and 5-HT2C receptor antagonsit/inverse agonist reduce hallucinations and delusions that often complicate late stage PD

28
Q

Anticholinesterase

A

AD tx: address loss of cholinergic pathway (nucleus of basalis of Meynert) to cortex

29
Q

Donepezil

A

moderate and severe disease; anticholinesterase for AD; inverse U dose response curve

30
Q

Rivastigmine

A

(Transdermal) anticholinesterase for AD inverse U dose response curve; moderate disease

31
Q

Galantamine

A

anticholinesterase for AD inverse U shaped dose response curve; moderate disease

32
Q

Memantine

A

weak NMDA receptor negative allosteric modulator (GLU); Alzheimers, combo with donepezil available now to tx AD

33
Q

Bapineuzumab

A

humanized monoclonal antibody to AB (alzheimer’s); reduces plaque but not cognitive protection

34
Q

Aducanumab

A

monoclonal antibody for AB in AD showed decrease in rate of progression of cognitive impairment as well as reduction in plaques

35
Q

Haloperidol and Fluphenazine

A

1st gen antipsychotics blocking D2 receptors for Huntingtons

36
Q

Olanzepine

A

2nd gen antipsychotic block D2 receptor Huntington

37
Q

VAMT2 inhibitors

A

block storage of DA and other monoamines in secretory vesicles (huntingtons)

38
Q

Tetrabenazine

A

VAMT2 inhibitor Huntingtons

39
Q

Duetetrabenazine

A

VAMT2 inhibitor Huntingtons

40
Q

Reserpine

A

VAMT2 inhibitor Huntingtons

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