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Pharm > Parkinson------------------------------------------------EXAM 2 > Flashcards

Parkinson------------------------------------------------EXAM 2 Flashcards

1
Q

Comp inhibitor
Uses for acting in periphery ( not enter CNS)
Levodopa inc brain penetr

A

Tolcapone & entacapone

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2
Q

Int: MAOI’s, catecholamines, methyldopa

MCM

A

Tolcapone & entacapone

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3
Q

ADR: (HDHD URINE CNS)

Hepatotoxicity, diarrhea
Hypotension, dyskinesia
Urine discolor,
Cramps, nausea, stomach upset

A

Tolcapone & entacapone

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4
Q

Inc Levodopa response time

A

Tolcapone & entacapone

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5
Q

Need to monitor w/ liver function tests

A

Tolcapone & entacapone

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6
Q

Metabolized in pheriphery by L-aminoacid decarboxylase.

A

Levodopa

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7
Q

Uses for cornerstone therapy for parkinson

A

Levodopa

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8
Q

Doesnt stop progression of parkinson’s ds

A

Levodopa

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9
Q

Int

Phenytoin, phenothiazine- dec effect
B6- inc peripheral conversion
MAOI- inc BP

A

Levodopa

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10
Q

AD: (Hi My Bloody GONADDS)
Gastrointestinal, cardiovascular, behavioral

Halluci
Mydriasis, Blood dyscrasias,
Gout, Orthostatic hypotension, Nausea ,Arrhythmia, Dyskinesia, Depression, Sleep disorders,

A

Levodopa

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11
Q

1/3 respond well, 1/3 not respond well

Best if given early

A

Levodopa

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12
Q

Response to drug decreases after 3-4 yrs

A

Levodopa

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13
Q

Best at bradykinesia

A

Levodopa

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14
Q

Antipsychotic agents

A

Clozapine, quetiapine, risperidone

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15
Q

Used in ratio w Levodopa to allow more to cross BBB

A

Levodopa

C:L=1:4, 1:10

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16
Q

Prevent GI symptoms in 80% of pt

A

Carbidopa

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17
Q

Take more often in smaller dose

Add Bromocriptine, selegiline, or decrease protein, drug holiday doesnt work

A

Carbidopa

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18
Q

MAO-B inhibitor

Blocks dopamine breakdown (prolongs Levodopa effect)

A

Selegrilline, Rasagilline

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19
Q

Int: ( flut meperidine general street)

Fluoxetine, TCA, Genanaes, meperidine, St. John

A

Selegrilline, Rasagilline

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20
Q

AD: (JIA)

Jitteriness, insomnia, inc AD of Levodopa

A

Selegrilline, Rasagilline

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21
Q

NMDA ant
Anti Ch
Anti viral

A

Amantadine

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22
Q

Helps w tremor

A

Amantadine

23
Q

Increase dopamine, blocks D reuptake, inc syn D recptor

A

Amantadine

24
Q

AD:

Anti-ch(dry mouth, sedation, vivid dreams)
CNS(depression, halluc, anxiety, dizz, psych, confusion)

A

Amantadine

25
Q

Int: (CHAAT)

Cns stim, hydrochlorothiazide, anti-ch, amiloride, triamiterene

Not use in seizure or CHF pt

A 
Trihexyphenidyl
Procyclidine
Benztropine
Biperidine
Diphenhydramine
26
Q

Anti-ch

use for rigidity, dystonia, tremor/ not help for bradykinesia

A 
Trihexyphenidyl
Procyclidine
Benztropine
Biperidine
Diphenhydramine
27
Q

AD

Older-> worsen
Dry mouth, urinary retention, confusion

A 
Trihexyphenidyl
Procyclidine
Benztropine
Biperidine
Diphenhydramine
28
Q

Anti-ch

A 
Trihexyphenidyl
Procyclidine
Benztropine
Biperidine
Diphenhydramine
29
Q

Not helpful for bradykinesis

A 
Trihexyphenidyl
Procyclidine
Benztropine
Biperidine
Diphenhydramine
30
Q

Ergot dopamine agonist

A

Bromocriptine

31
Q

Bind to post-synaptic dopamine receptors and enhance transmission

Not increase dopamine concentration

Prolongs effective treatment period for levodopa

A

Bromocriptine

32
Q

Int:

Tolcapone causes hepatotoxicity (black box warning) & neuroleptic malignant syndrome

A

Bromocriptine

33
Q

Int

MAOI- can cause neuroleptic malignant syndrome

A

Bromocriptine

34
Q

Dont use in pts w MI or in psychotic pt

A

Bromocriptine

35
Q

AD: (DOHA RIP CARDD)

Diarrhea, orthostatic hypotension, hallucination, anorexia, rhabdomyolysis, impulse problem(add like), pleural fibrosis, cardiac arrhythmias, digital vasopasms, dyskinesias

A

Bromocriptine

36
Q

Decrease incidence of dyskinesias than Levodopa

A

Bromocriptine

37
Q

Can be given w carbidopa, levodopa, or to refractory pt

A

Bromocriptine

38
Q

1st line drug for parkinson

A

Bromocriptine+ Levodopa

39
Q

Non-ergot agonist

A

Ropinirole
A
P

40
Q

Prolongs effective treatment period for Levodopa

A

Ropinirole

41
Q

Uses for restless leg syndrome

A

Ropinirole

Pramipexole

42
Q

Int: (CEO)

Ciprofloxacine, estrogen, omeprazole

A

Ropinirole

43
Q

AD: DOH(a) RI(p)

Diarrhea, ortho hypo, halluc, rhabdo, impulse

A

Ropinirole
Apomorphine
Pramipexole

44
Q

Decrease risk of dyskinesia for pts on Levodopa

A

Ropinirole

45
Q

Used early in course as monotherapy or w Levodopa

A

Ropinirole

46
Q

Use for acute treatment of severe rigidity or inability to move

Used as a rescue therapy-injectable and fast-acting

A

Apomorphine

47
Q

Int:

Tolcapone-
MAOI’s-
Ondansetron-

A

Apomorphine

48
Q

Int:

Tolcapone-causes hepatoxicity(black box warning) & neuroleptic malignant syndrome

MAOI’s- can cause neuroleptic malignant syndrome

Ondansetron-causes hypotension

A

Apomorphine

49
Q

It’s emetic agent (induces vomiting) so pts need an antiemetic

  • trimethobenzamide (antiemetic given w apomorphine)
A

Apomorphine

50
Q

Bind to post-syn D receptors; potent at D2,D3, D4

Prolongs levodopa period

A

Pramipexole

51
Q

Int:

Tolcapone
MAOI

A

Pramipexole

52
Q

No systemic metabolism

When use w Levodopa, can decrease Levodopa 30%

A

Pramipexole

53
Q

Parkinson’s

A

TEL MA BRO to RAP and TRI PRO BENZ BIDI

TEL- tolcapone, entacapone/ levodopa
MAO- B inh: selegrilline, rasagilline
Amantadine

Bromocriptine

Ropinirole
Apomorphine
Pramipexole

Trihexyphenidyl, procyclidine, benztropine, biperidine, diphenhydramine

Pharm (19 decks)

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