Other Parkinson Drugs

Question 1

COMT inhibitors

Answer 1

Tolcapone and entacapone (inhibit levodopa peripheral metabolism to prolong effect)

Tolcapone- both CNS/PNS effects (other PNS only). Has rarely been assoc w/ death from acute hepatic failure

Question 2

Apomorphine

Answer 2

D2 receptor

Give SC for quick relief off-period of akinesia

Side effect: nausea (give trimethobenzamide before to prevent)

Question 3

Amantadine

Answer 3

Antiviral agent, MOA unknown

Half life 2-4 hrs, peak conc 1-4 hrs

May cause livedo retucularis (vascular condition- purplish mottled discoloration of skin, usually legs)

Question 4

Anti cholinergic drugs

Answer 4

Improve tremor/rigidity but little effect on Bradykinesia

Includes: benzotropine, biperiden, orphenadrine, procyclidine, trihexyphenidyl

Side effects: peripheral anti cholinergic effects