Neurologic Disorder Drugs

Question 1

Carbidopa-Levodopa

Answer 1

• Used for PD
• Dopaminergic
• MOA: dopamine replacement
• Effectiveness decreases after 5 years of treatment
• Short duration so need to take frequent doses
• Side effects: dystonia, dyskinesia, akathisia, psychosis, anticholinergic effects for PNS, brown discoloration or urine & sweat, N/V (need to report),
• Do not abruptly discontinue
• Avoid pyridoxine (B6 reduces effects; fortified cereal, meat/poultry/fish/soybean)
• Monitor skin for malignant melanoma
• Monitor blood cell counts (leukopenia, thrombocytopenia)

“Wearing Daisy Dukes Always Prompts Penises. But Nadia & Vlad Prefer Male Models Like Thor”

Question 2

Amantadine

Answer 2

• For PD
• Dopamine agonist
• MOA: improves dopamine action
  - also antiviral drug for influenza A
• Side effects: livedo reticularis (temporary skin discoloration) & anticholinergic effects
• Drug tolerance develops
• Do not discontinue abruptly

“A man can’t model with mottled skin”

Question 3

Benztropine

Answer 3

• For PD
• Anticholinergic
• MOA: inhibits release of acetylcholine in the CNS
• Side effects: anticholinergic effects in the PNS, dystonia (posture stiffness), contraction, twitching, distortions & spasms
• Contraindications: hx of Alzheimer’s or MG

“Don’t Call Tom, Sad Day”

Question 4

Donepezil & Memantine

Answer 4

• For Alzheimer’s
• Cholinesterase inhibitors (AChE-I)
• MOA: prevents the breakdown of ACH & improves cognitive function
• Side effects: dizziness, insomnia, headache, anorexia, muscle cramps

“Im Done Having Absent Memory”

Question 5

Edrophonium, Neostigmine & Pyridostigmine

Answer 5

• For MG
• Cholinesterase inhibitors
• MOA: preventing the destruction of ACh
• Side effects: cholinergic effects on PNS
• Ex:
  - Edrophonium: ultra-short acting for diagnosing
  - Neostigmine: short-acting for treatment of acute myasthenic crisis
  - reversal agent for vecuronium
  - Pyridostigmine: intermediate-acting for maintenance therapy of MG