Parkinson's treatment Flashcards
MOA of Levodopa
Increases DA levels in the brain. Usually given with carbidopa (Synemet)
Levodopa enters brain by L-amino acid transporter, but dopamine does not
MOA of Carbidopa
Peripheral dopa decarboxylase inhibitor
MOA of Selegiline, Rasagiline
MAO-B inhibitors
MOA of Entacopone, Tolcapone
Inhibit COMT and enhance levodopa uptake and efficacy
Tolcapone: peripheral and central action
Entacapone: peripheral action (less toxicity)
MOA of Ropinirole, Pramipexol
Non ergot D agonists
Ropinirole is D2 agonist
Pramipexole is D3 agonist and scavenges H2O2
MOA of Amantadine
Antiviral drug used to treat influenza A virus infection
Increases dopamine release
MOA of Benztropine, Trihexyphenidyl
M blockers
Uses of Levodopa
Usually given with carbidopa (Synemet)
Uses of Carbidopa
Usually given with levodopa (Synemet)
Uses of Selegiline, Rasagiline
Useful in the initial treatment of Parkinson’s disease and as an adjunct to levodopa
Effective in MPTP-induced Parkinsonism
Uses of Entacopone, Tolcapone
Mainly used in combination with L-DOPA, it increases the half-life of L-DOPA. Delays “wearing-off” effect of L-DOPA and other motor complications such as dyskinesia
Uses of Ropinirole, Pramipexol
Preferred D2 agonists in the treatment of Parkinson’s
Uses of Benztropine, Trihexyphenidyl
Decrease tremor and rigidity but have little effects on bradykinesia
ADR of Levodopa
Arrhythmias Hypertension Psychosis Hypotension Vomiting Dyskinesia Response fluctuation (after 10y use)
ADR of Selegiline, Rasagiline
May enhance adverse effects of L-dopa.
Dyskinesia
Psychosis
Insomnia
