Parkinson's And Alzheimer's

Question 0

Dopamine receptor agonists

Answer 0

1st line for PD
Ae: nausea, peripheral edema, hypotension
Apomorphine, pramipexole, ropirinole, amantadine, rotigotine, bromocriptine

Question 1

Carbidopa-levidopa(sinemet)

Answer 1

For idiopathic pd, post encephalitic parkinsonism, symptomatic parkinsonism, Greatest anti parkinson efficacy
Can cause hypomobility after 4years get tolcapone(metab inhibitor)
Food ingestion delays absorption
C/i for melanome

Question 2

Apomorphine

Answer 2

Non ergot
For acute intermittent treatment of off episodes
Pretreatment with antiemetic trimethobenzamide is recommended
Nausea, dyskinesia, drowsiness, chest pain

Question 3

Pramipexole(mirapex)

Answer 3

Non ergot
Mono and adjunct to levodopa/PDI
D3 is preferred; neuroprotective effect

Question 4

Ropirinole

Answer 4

Mono in early disease and adjunct to levodopa/PDI

Stimulation of d2 receptors in the striatum

Question 5

Amantadine

Answer 5

For: same as caridopa levodopa
Moa: inc synthesis, release, reuptake
SE: cns(restlessness, depression, irritability, insomnia, agitation, excitement, hallucinations, confusion) , liverdo reticularis
C/i: seizures and heart failure

Question 6

Rotigotine

Answer 6

Early pd
Stimulate d2 receptors within the striatum
Stimulates d3,d2,d1
Available as patch for 24 hrs

Question 7

Bromocriptine

Answer 7

Ergot da
D2 antag
Git absorption, peak at 1-2hrs

Question 8

Deprenyl(SELEGILINE)

Answer 8

Selectively and reversibly inhibits MAO- B, adjunct for levodopa
Forms toxic metabolite such as amphetamine- sleepy and confuse

Question 9

Rasagaline(Selegiline)

Answer 9

Newer mao b inhibitor does not form toxic metab

Question 10

Tolcapone and entacapone

Answer 10

Tolcapon: lipid soluble, can cross BBB(central and peripheral)
Entacapone: peripheral
Dec peripheral metab of ldopa and inc availability of levodopa
Treat wearing off responses
Tolcapone- hepatotoxic

Question 11

Trihexyphenidyl

Answer 11

Synthetic tertiary amine anticholinergic agent
Adjuvant with levodopa; initial pd with tremors
Direct antispasmodic action on smooth muscle

Question 12

Benztropibe mesylate

Answer 12

Adjunct for all forms of pd
Partially blocks striatal cholinergic receptors
Block dopamine reuptakeq

Question 13

Donepezil(aricept)

Answer 13

Mild sever ad
Non competitive ache inhibitor
Se: parasympa effects
Di: carbamazepine, dexamethasone

Question 14

Rivastigmine

Answer 14

mild moderate ad and pd dementia
Non competitive
Patch
Similar to tagmine but less
Di: cimetidine and erythromycin

Question 15

Galantamine

Answer 15

Adjunct for severe dementia, mild moderate ad
Competitive
Abs cramps, anorexia, nauseavomiting, diarrhea
Di: cimetidine and erythromycin

Question 16

Memantine (namenda)

Answer 16

Most commonly used for severe types of dementia, moderate to severe ad
Nmda receptor antagonist
Nmdare ceptor induce memory loss
Mild reversible headache or dizziness