Neurological disorder drugs

Question 1

Levodopa - ADRs?

Answer 1

Dopamine receptor agonist

Dopamine cannot cross BBB

Nausea/anorexia
Hypotension
Psychosis

High protein meals compete across BBB
Vit B6 - ^peripheral breakdown of levodopa

Question 2

Co-careldopa

Answer 2

Levodopa + peripheral dopa decarboxylase inhibitor

Question 3

Entacapone

Answer 3

COMT inhibitor

Reduces peripheral breakdown of levodopa

Question 4

Selegiline, Rasagaline

Answer 4

Monoamine Oxidase B inhibitor

Prevents dopamine metabolism

Question 5

Ropinirole

Answer 5

Dopamine receptor agonist

Add on therapy

Question 6

Orphrenadine, Procyclidine

Answer 6

Anticholinergic

Inhibits Ach (for problematic tremor)

Question 7

Acetylcholinesterase Inhibitors - ADR?

Answer 7

Pyridostigmine (oral)
Neostigmine

Stops breakdown of Ach

Sweating
Salivation
Lacrimation
Urinary incontinence
Diarrhoea
GI upset
Emesis

Question 8

What drugs should you caution prescribing as they worsen myasthenia gravis?

Answer 8

ACE-i
B blockers
CCB

Question 9

Which anti-emetic should you not give to a patient with parkinson’s?

Answer 9

Metoclopramide (D2 antagonist)

Domperidone acts on A2 but doesn’t cross BBB