Parkinson's drugs

Question 1

What is the mechanism of carbidopa?

Answer 1

It inhibits dopa decarboxylase, but it doesn’t cross the BBB, so it only blocks conversion of L-DOPA to dopamine in the periphery

Question 2

Amantadine: Mechanism of action and side effects

Answer 2

NMDA antagonist

hallucinations

livedo reticularis

insomnia

anticholinergic side effects (dry mouth, urinary retention, constipation)

Question 3

What is use of MAO-B inhibitors in PD? Name the drugs

Answer 3

MAO-B breaks down dopamine

MAO-B inhibitors prevent degradation of dopamine

selegiline and rasagaline

Question 4

Name 5 non-dopamine dopaminergic agonists.

Answer 4

1. apomorphine
2. pramipexole
3. bromocriptine
4. rpinirole
5. ritogotine

Question 5

What are the advantages of the non-dopamine dopaminergics?

Answer 5

longer half lives

less associated with motor fluctiations

fewer dyskinesias

Question 6

What are the disadvantages of non-dopamine dopaminergics?

Answer 6

Not as effective as carbidopa-levodopa

More likely to have adverse effects (nausea, orthostastic hypotension, fatigue, hallucinations, psychosis, impulse control disorders)

Question 7

what class of medication is selegeline? Why is it used in PD?

Answer 7

MAO-B inhibitor

MAO-B breaks down dopamine

Question 8

Mechanism of action of ropinirole and pramipexole

Answer 8

D2/D3 agonists

Question 9

PD therapy that causes impulse control problems

Answer 9

dopamine aonists