Parkinson Disease Drugs Flashcards
Levodopa, COMT inhibitors, Dopamine agonists, MAO-B inhibitors, Anticholinergics, and Amantadine are all drugs used to treat _____ disease
Parkinsons
Selegilline and Rasagilline are both ______ ______
MAO-B Inhibitors
Trihexyphenidyl, Benztropine mesylate, biperiden, orphenadrine, and Procyclidine are all Centrally acting _____ ______
Anti-Muscarinics
Unlike dopamine, the therapeutic drug ____, crosses the BBB
Levodopa
3 Non-Ergot Dopamine Agonist drugs
- Ropinirole (D2+)
- Pramipexole (D3+)
- Rotigotine
Similar to tolcapone, _____ blocks COMT, but only in the periphery
Entacapone
A _____ tremor is found in Parkinsons
Resting
Tolcapone inhibits the enzyme ______, which prevents the metabolism of Dopamine into 3-OMD in BOTH central and peripheral
COMT
A high protein meal will ____ absorption of Levodopa
Delay
2 drugs that metabolize Levodopa in peripheral tissues
- L-AAD
2. COMT
3 Medical conditions that Contraindicate Levodopa
- Psychosis
- Glaucoma (Angle-closure , Acute)
- Peptic Ulcers
In peripheral tissues, L-Aromatic Amino acid decarboxylase (L-AAD) and Catechol-O-methyltransferase (COMT) will transform Levodopa. The main decarboxylase inhbiitor used to bypass the peripheral transormation is ______
Carbidopa
Ropinirole, which is metabolized by _____ and Pramipexole, which is excreted unchanged in urine, are both ______ Derivatives used to treat Parkinsons via Dopamine ______
- CYP1A2
- Non-Ergot
- Agonisms
Plasma Half-life of Levodopa is ____ to _____ hours
1-3
Studies suggest that Rasagiline and Selegiline might have a ______M effect, by preventing the buildup of _______
- Neuroprotective
- Free-radicals
MAO ______ the amount of dopamine present in the body
Decreases
What is Stalevo? (3 things)
Levo, Carbidopa, and Entacapone combined
2 main CNS side effects of Levodopa
- Dyskinesias
2. Psych Disturbances
The recreational drug MPTP becomes radicalized into ______ and produces oxidative stress killing DA neurons
MPP+
_____% of cells in the substantia nigra nieed to be lost before Parkinsons symptoms can be seen
80
Why is Tolcapone less preferable than entacapone
No incidence of hepatotoxicity
Clozapine is an anti-_____ class of drugs that does not worsen Parkinsons
psychotic
Bromocriptine is an Ergot derivative which serves as a _____ agonist
D2
D1 receptors are generally ______ whereas D2 receptors are generally _____
Excitatory, Inhibitory
The main adverse effect of Ergot agents that separates them from other drugs is ______
Vasoconstriction
Two terrible Drug interactions with Levodopa
- Pyridoxine
2. MAO-A ihhibitors
What is special of the Dopamine agonists Apomorphine’s administration?
- Subcutaneous and grants benefits within 10 minutes of injections
Levodopa becomes DA via a _____ reaction
Decarboxylation
The main Dopamine Agonist that is a ergot derviative is _____
Bromocriptine
3 main GI side-effects of Levodopa without decarboxylase inhibitor
- Anorexia
- Nausea
- Vomiting
Prampipexole, Ropinirole, Bromocriptine, Pergolide are all ______ _____ drugs
Dopamine Agonsits
Sinemet is a combination of ____ and ___
- Levodopa
- Carbidopa
MAO-_____ metabolizes dopamine selectively, wherease MAO-_____ metabolizes NE, SA, and DA
- B
- A
What is special about the adminstration of Rotigotine DA agonist?
- Via once-daily transdermal patch
3 main Cardio side-effects of Levodopa
- Arrhythmias
- Postural hypotension
- Combo with MAO inhibit causes HTN!
