Neurogenerative Diseases

Question 1

Levodopa MOA

Answer 1

increases dopament synthesis

Question 2

Selegiline

Answer 2

Inhibits dopamine breakdown

• inhibits monoamine oxidase type B (MAO-B)

Indicated; single drug for early/ mild PD, adjunct to levodopa-carbidopa for advanced disease (reduces need to >> levodopa dosage).

++ can improve motor function in patients who experience wearing off and on-off difficulties with Levodopa.

Question 3

Carbidopa and entacapone

Answer 3

increases the amount of levodopa that enters the brain

Question 4

What’s the relationship of Levodopa and protein?

Answer 4

Levodopa is absorbed from the proximal duodenum.

Amino acids compete with levodopa for transport into circulation.

Therefore high protein meals can decrease effectiveness of levodopa.

NB> Vit B₆ should not be adminstered wthi levodopa.

Question 5

Donzepezil

Answer 5

Alzheimer’s Disease

Increases availability of acetylcholine in the brain.

Central Acetylcholinesterase Inhibitor

Question 6

Why is it important to combine carbidopa with levodopa?

Answer 6

To block the peripheral formation of dopamine. Dopamine acts on B-adrenoceptors and can cause arrhythmias.

Adverse effects of levodopa:

80% px - nausea and vomiting

25% px - orthostatic hypotension

10% px - cardiac dysrhythmia

Question 7

What’s the problem with long-term adminstration of Levodopa?

Answer 7

Dyskinesias; oral and facial musculature. Px appear if they are chewing on large pieces of food while protruding their lips.

Also; writhing and flinging movements of arms and legs. Rarely psychotic effects.

Question 8

Bromocriptine (ergot alkaloid)

D₂ receptor agonist and D₁ receptor antagonist

Answer 8

Combined with levodopa in patients with advanced PD and who experience wearing off and on-off motor fluctuations.

Question 9

Ropinirole (not ergot alkaloids)

• selective D₂ receptor agonists

Answer 9

Can delay the need for levodopa when used in early stages of PD.

Also indicated for restless leg syndrome.

Question 10

Drugs for Huntington Disease

Answer 10

Diazepam

Haloperidol

Question 11

Drugs for MS

Answer 11

Baclofen

Interferon beta-1b

Prednisone

Question 12

Three drugs used to treat Alzheimer’s disease

Answer 12

Donepezil

Rivastigmine

Galantamine

Question 13

Amantadine

Answer 13

Increases dopamine release in the basal ganglia; used for Parkinson’s disease

Question 14

Memantine

Answer 14

New drug to treat AD

NMDA receptor antagonist