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Therapeutics III > Parkinson's > Flashcards

Parkinson's Flashcards

1
Q

Carbidopa/Levodopa

A

dopamine precursor
carbidopa prevents degradation of levodopa by DOPA decarboxylase
levodopa is broken down to dopamine in the CNS

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2
Q

Bromocriptine and cabergoline

A

Ergot Dopamine Agonist

cardiac/pulmonary toxicity

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3
Q

Apomorphine

A

SQ mixed D1/D2 agonist
Used in late stage only
N/V

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4
Q

Pramipexole (Mirapex)

A 
Dopamine agonist
No motor fluctuations 
long acting formulations
Impulse control disorder
starting dose: IR 0.125 mg TID, ER 0.375 daily
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5
Q

Ropinirole (Requip)

A 
Dopamine agonist
No motor fluctuations
long acting formulations
impulse control disorder
Starting dose: IR 0.25mg, ER 2mg daily
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6
Q

Rotigotine (Neupro)

A 
Dopamine agonist
patch
No motor fluctuations
 long acting formulations
Impulse control disorder
Starting dose: 2mg patch q24 hours
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7
Q

Rasagiline (Azilect)

A 
MAO-B inhibitor
may benefit pts with depression
2nd line therapy
Starting dose:  0.5mg daily
Risk of serotonin syndrome
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8
Q

Selegiline (Eldepryl)

A 
MAO-B inhibitor
may benefit pts with depression
2nd line therapy
Starting dose:  5mg BID
Risk of serotonin syndrome
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9
Q

Entacapone (Comtan)

A

COMT inhibitor- decreases LD metabolism in periphery
Only add to LD if the pt is having motor fluctuations
Starting dose: 200mg with each LD dose

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10
Q

Tolcapone (Tasmar)

A

COMT inhibitor- decreases LD metabolism in periphery and CNS
Only add to LD if the pt is having motor fluctuations
Hepatotoxicity
Starting dose: 100mg TID

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11
Q

Amantadine (Symmetrel)

A

Management of LD motor fluctuations
Rarely used as a monotherapy
Used to treat CD/LD peak dose dyskinesias
Starting dose: 100mg BID

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12
Q

Benztropine (Cogentin)

A

Anticholinergic
Used to manage tremor in pts less than 65 years old
usual anticholinergic SE’s
Starting dose: 0.5 mg qhs

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13
Q

Trihexyphenidyl (Artrane)

A

Anticholinergic
Used to manage tremor in pts less than 65 years old
usual anticholinergic SE’s
Starting dose: 1mg daily

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14
Q

Which insomnia-treating drugs should be avoided in PD?

A

Benzodiazepines (diazepam, lorazepam, etc)

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15
Q

What drugs should be used to treat anxiety/depression in a patient who has PD?

A

SSRI, SNRI

AVOID BENZODIAZEPINES AND CAUTION TCA’S

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16
Q

What drugs should be used to treat dementia in a patient with PD?

A

cholinesterase inhibitors

AVOID ANTICHOLINERGICS, BENZOS, ANTIHISTAMINES, SEDATIVES

17
Q

What drugs should be used to treat psychosis in a patient with PD?

A

1st try reducing PD medication doses
Pimavanserin
atypical antipsychotics (clozapine, quetiapine)
AVOID: HALOPERIDOL, OLANZAPINE, PALIPERIDONE, RISPERIDONE

Therapeutics III (11 decks)

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