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Pharmacology > Neurology Pharmacology > Flashcards

Neurology Pharmacology Flashcards

1
Q

What classes of medication are used for Parkinson’s disease?

A 
Dopamine precursor 
Dopamine receptor antagonists 
Monoamine oxidase B inhibitors
COMT inhibitors 
Anticholinergics
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2
Q

Why is dopamine not used in treatment for Parkinson’s?

A

Unable to cross BBB

L-DOPA is moved across by active transport

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3
Q

What are some examples of dopamine precursors?

A

Levodopa

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4
Q

What does levodopa need in order to be able to act?

A

Sufficient dopaminergic cells in the substantia nigra to convert L-DOPA to dopamine

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5
Q

What is the route of administration for levodopa?

A

Oral

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6
Q

What is the mechanism of levodopa?

A

Crosses blood brain barrier

Converted to dopamine

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7
Q

What are the side effects of levodopa?

A

Nausea
Hypotension
Psychosis
Tachycardia

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8
Q

What other drugs contain levodopa?

A

Co-careldopa

Co-beneldopa

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9
Q

What is combined with levodopa?

A

Peripheral DOPA decarboxylase inhibitor

- prevent breakdown on DOPA

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10
Q

What is the drug name of co-careldopa?

A

Sinemet

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11
Q

What is the route of administration for co-careldopa?

A

Oral

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12
Q

What are the side effects of co-careldopa?

A

Nausea

Drowsiness

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13
Q

What is the name of the DOPA deycarboxylase inhibitor in co-careldopa?

A

Carbidopa

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14
Q

What is the name of the DOPA decarboxylase inhibitor in co-beneldopa?

A

Benserazide

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15
Q

What is the drug name of co-beneldopa?

A

Madopar

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16
Q

What is the route of administration for co-beneldopa?

A

Oral

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17
Q

What are the side effects of co-beneldopa?

A

Nausea
Anxiety
Postural hypotension

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18
Q

What are the advantages of levodopa?

A

Highly efficient

Low side effects

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19
Q

What are the disadvantages of levodopa?

A

Precursor - needs enzyme conversion

Long term effects

  • loses efficiency
  • involuntary movements
  • motor complications
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20
Q

What are examples of dopamine receptor agonists?

A

Ropinirole
Rotigotine
Apomorphine

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21
Q

What is the indication for apomorphine?

A

Parkinson’s patients with severe motor fluctuation

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22
Q

What is the route of administration for apomorphine?

A

Subcutaneous

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23
Q

What is the mechanism of apomorphine?

A

Activates dopamine receptor

Compensates for depleted supply of endogenous dopamine

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24
Q

What are the side effects of apomorphine?

A 
Confusion 
Dizziness
Drowsiness
Nausea
Psychiatric disorders
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25
Q

What is the route of administration for ropinirole?

A

Oral

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26
Q

What is the mechanism of ropinirole?

A

Activates dopamine receptor

Compensates for depleted supply of endogenous dopamine

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27
Q

What are the side effects of ropinirole?

A 
Confusion 
Dizziness
Drowsiness
Sleep disorders
N+V
28
Q

What is the route of administration for Rotigotine?

A

Transdermal patch

29
Q

What is the mechanism of Rotigotine?

A

Activates dopamine receptor

Compensates for depleted supply of endogenous dopamine

30
Q

What are side effects of Rotigotine?

A 
Abnormal behaviour 
Dizziness
Drowsiness
N+V
Psychiatric disorders
31
Q

What are the advantages of dopamine receptor agonists?

A

Direct acting

Less motor complications

Possible neuroprotection

32
Q

What are the disadvantages of dopamine receptor agonists?

A

Less efficient that L-DOPA

Impulse control disrders

More psychiatric side effects

Expensive

33
Q

What are examples of monoamine oxidase B inhibitors?

A

Selegiline

Rasagaline

34
Q

What is monoamine oxidase B?

A

Enzyme that metabolises dopamine

Predominantly in the dopamine containing regions of the brain

35
Q

What is the mechanism of MAO B inhibitors?

A

Inhibits monoamine oxidase type B

Prevents metabolism of dopamine

More dopamine present

36
Q

What is the route of administration of Selegiline?

A

Oral

37
Q

What are the side effects of selegilline?

A 
Arrhthymias
Back pain 
Confsion 
Nausea
Headache
Hallucination
38
Q

What is the route of administration for Rasagiline?

A

Oral

39
Q

What are the side effects of Rasagiline?

A 
Abdo pain 
Depression 
Postural hypotension 
Depression 
Sleep disorders
40
Q

What is an example of a COMT inhibitor?

A

Entacapone

41
Q

What is COMT?

A

Catechol-O-methyl transferase

Breaksdown dopamine peripherally

42
Q

What is the route of administration of Entacapone?

A

Oral

43
Q

What is the mechanism of Entacapone?

A

Inhibits COMT

Reduces peripheral L-DOPA breakdown

44
Q

What are the side effects of Entacapone?

A 
Abdo pain 
Confusion 
Dizziness
Hallucination 
Movement disorders
N+V
45
Q

Which anticholinergics are used in the treatment of Parkinsons?

A

Trihexyphenidyl
Orphenadrine
Procyclidine

46
Q

What is the mechanism of anticholinergics used in Parksinsons?

A

Inhibit ACh - treat tremor

Antispasmodic effect on smooth muscle

Balances cholinergic and dopaminergic activity in basal ganglia

47
Q

What is the route of administration of Trihexyphenidyl?

A

Oral

48
Q

What are the side effects of trihexyphenidyl?

A 
Anxiery 
Confusion 
Flushing 
Dry mouth 
Vomiting
49
Q

What is the route of administration of orphenadrine?

A

Oral

50
Q

What are the side effects of orphenadrine?

A

Anxiety
Dizziness
Dry mouth
Nausea

51
Q

What is the route of administration of procyclidine?

A

Oral

52
Q

What are the side effects of procyclidine?

A

Constipation
Dry mouth
Urinary retention
Blurry vision

53
Q

What are the advantages of anticholinergics?

A

Treat tremor

Do not act via dopamine systems

54
Q

What are the disadvantages of anticholinergics?

A

No effect on bradykinesia

Side effects

55
Q

What other drug is used to treat Parkinsons?

A

Amantadine

56
Q

What is the mechanism of amantadine?

A

Unknown

Possibly

  • enhance dopamine release
  • anticholinergic NMDA inhibition
57
Q

What is the route of administration of amantadine?

A

Oral

58
Q

What are the side effects of amantadine?

A 
Anxiety 
Confusion 
Constipation 
Depression 
Movement disorders
59
Q

What drugs is used to manage myasthenia gravis?

A

Pyridostigmine

Neostigmine

60
Q

What class are pyridostigmine/neostigmine?

A

Anticholinesterase inhibitors

61
Q

What is the indication for neostigmine?

A

Use in ITU
Quicker action
IV + oral preparations

62
Q

What is the mechanism of anticholinesterase inhibitors in myasthenia gravis?

A

Inhibit cholinesterase

More circulating ACh

Enhances neuromuscular transmission

63
Q

What is the route of administration of pyridostigmine?

A

Oral

64
Q

What is the pneumonic for antimuscarinic side effects?

A

SSLUDGE

65
Q

What are the side effects of pyridostigmine?

A 
Salivation 
Sweating 
Lacrimation 
Urinary incontinence
Diarrhoea
GI upset
Emesis

Miosis

Pharmacology (27 decks)

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