Parkinson's Flashcards
Dopamine receptor agonists
Pramipexole
Rotigotine
Dopamine synthesis adjuvants
Levodopa
Carbidopa
MAO inhibitors
Selegiline
COMT inhibitors
Entacapone
Anticholinergics
Trihexyphenidyl
Antiviral
Amantadine
Parkinson’s disease
Degradation of the nigrostriatal dopamine neurons -> not enough dopamine
Symptoms of Parkinson’s disease
Tremor at rest (3)
Rigidity (2)
Akinesia or bradykinesia (1)
Postural instability: loss of normal postural reflexes (4)
Levodopa
Most successful and used
Bypasses rate-limiting step of dopamine synthesis->more dopamine
Dose must be individualized and given with carbidopa (blocks metabolism of levodopa in periphery and reduces side effects)
Can cause dyskinesia at high doses
Postural hypotension
Psychosis
Depression, daytime somnolence, compulsive bx
Carbidopa
Allows lower doses of levodopa
Reduces levodopa degradation in periphery and reduces its side effects (used in combo)
Pramipexole
Dopamine receptor agonist (D2)
Rotigotine
Dopamine receptor agonist
Patch
Selegiline
MAO inhibitor type B»>A
Reduces first pass metabolism of Levodopa and dopamine
Reduces motor fluctuations esp end of dose wearing off
Has amphetamine metabolites that may produce agitation and insomnia
May increase central side effects of levodopa
Entacapone
COMT inhibitor
Block levodopa metabolism by COMT in periphery
Dyskinesia (increases central side effects of levodopa)
Trihexyphenidyl
Anti cholinergic
The dopamine-Ach balance hypothesis of striatal function
Too little dopamine, allowing Ach to dominate the striatum
