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Neurodegenerative Disease Flashcards

1
Q

Levodopa

A

Parkinsons

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2
Q

Levodopa MOA

A

metabolic precursor to Dopamine. Becomes dopamaine to restore post-synaptic concentration of dopamine. Activates post-synaptic D1 and D2 receptors

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3
Q

Carbidopa

A

inhibits dopa decarboxylase to allow levodopa to enter the BBB

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4
Q

Levodopa contraindications

A

MAOI use, history of malignant melanoma, narrow angle glaucoma. Monitor LFT

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5
Q

Levodopa ADR

A

Dyskinesias, “on-off” effect, Nausea, anorexia, hypotension, confusion, insomnia, nightmares, schizophrenic like syndrome

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6
Q

Dopamine Agonists

A

apomorphine, bromocriptine, pergolide, pramipexole, ropinirole, rotigotine

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7
Q

Dopamine Agonists ADR

A

N/V, anorexia, hypotension, cardiac arrythmias, HA, confusion, hallucinations, sedation, pulmonary fibrosis

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8
Q

Ergot Dopamine Agonists

A

Bromocriptine and Cabergoline. D2 receptor agonists

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9
Q

NonErgot Dopamine Agonists

A

Pramipexole, Ropinerole, Rotigotine (patch), Apomorphine

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10
Q

Pramipexole indications

A

advanced Parkinsons and restless leg syndrome

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11
Q

Ropinerole indications

A

monotherapy in mild parkinsons and restless leg syndrome

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12
Q

Rotigone ADR

A

sudden somnolence

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13
Q

Apomorphine receptor type

A

D1/D2

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14
Q

Pramipexole receptor type

A

D3. some D2/D4

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15
Q

Ropinerole receptor

A

D2

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16
Q

Apomorphine indications

A

subQ injection for temporary relief of “off” periods

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17
Q

Apormorphine ADR

A

dyskinesias, drowsiness, sweating, hypotension

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18
Q

Selegiline MOA

A

monoamine oxidase- B inhibitors

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19
Q

Selegiline indications

A

effective as monotherapy or in combination with levodopa for parkinsons. enables reduction in levodopa

20
Q

Selegiline ADR

A

blocks MAO-A at high doses, fatal hyperthermia

21
Q

Rasagiline MOA

A

irreversible MAO-B inhibitor

22
Q

Rasagiline indications

A

early treatment of Parkinsons and as adjunct with Levodopa

23
Q

Rasagiline metabolism

A

extensive liver metabolism. metabolized at CYP1A2.

24
Q

Rasagiline Drug interactions

A

meperidine, dextramethorphan, St. Johns Wort, cyclobenzaprine, ciprofloxacin

25
Q

Catechol-O-Methyltransferase inhibitors

A

Tolcapone, entecapone

26
Q

COMT inhibitors MOA

A

inhibits metabolism of dopamine. increase availability of Ldopa

27
Q

COMT indications

A

adjunct treatment for Parkinsons with levodopa

28
Q

COMTI ADR

A

increased plasma concentration of Ldop (dyskinesias, nausea, confusion), Diarrhea, abd pain, orthostatic hypotension, sleep disorders, orange urine discoloration. Tolcapone may be hepatotoxic

29
Q

COMT pearls

A

do not use MAO-A and COMT together. MAO-B may be okay. Entacapone=P450 inhibitor. Taper dosing for discontinuation

30
Q

Stalevo

A

Levodopa + Carbidopa + entacapone

31
Q

Amantadine

A

Antiviral drug with anti-parkinsonian properties

32
Q

Amantadine ADR

A

primarily CNS- restlessess, depression, irritability, insomnia, agitation, excitement, hallucinations, confusion, seizures. HA, edema, postural hypotension, HF, GI

33
Q

Anticholinergics MOA

A

dopamine def augment excitatory cholinergic system. blocks this system

34
Q

Anitcholinergics

A

Trihexyphenidyl and Benztropine

35
Q

AA of Neuro guidelines

A

Selegiline first, Levodopa or dopamine agonist, Alternative- exercise, speech therapy

36
Q

Cholinesterase inhibitors Indications

A

First line in Alzheimers

37
Q

Cholinesterase inhibitors

A

Donezepil, Rivastigmine, Galantamine

38
Q

Donezepil ADR

A

Cholinergic side effects , NVD, insomnia, fatigue, muscle cramps

39
Q

Donezepil interactions

A

metabolized by P450

40
Q

Rivastigmine ADR

A

NVD and weight loss, dyspepsia, sinusitis, dizziness

41
Q

Galantamine MOA

A

dual MOA. Competitive inhibition of acetylcholinesterase and allosteric modulation of presynaptic and postsynaptic nicotinic receptors

42
Q

Galantamine ADR

A

N, weight loss, agitation and diarrhea

43
Q

NMDA receptor Antagonists

44
Q

Memantine

A

noncompetitive NMDA receptor antagonist. increased glutamate release in CNS produces excitotoxic reactions and cell death, idea is to block this.

45
Q

Memantine ADR

A

agitation, Diarrhea, insomnia, dizziness, HA, Hallucinations

Pharmacology (33 decks)

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