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Pharm II Test 2 > Parkinsonism > Flashcards

Parkinsonism Flashcards

1
Q

L-Dopa- Mech of Action

A

DOPAMINE PRECURSOR

CROSSES BBB, IS CONVERTED TO L-DOPA, IS THEN TRAPPED IN THE BRAIN

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2
Q

L-Dopa- Absorption, Distribution

A

Low bioavailability

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3
Q

L-Dopa- Elimination

A

L-Dopa half life 1-3hrs

Increased by an additional 1-3hrs by addition of carbidopa

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4
Q

L-Dopa- Clinical Use

A

Given in combination
Parkinson’s (especially the bradykenisia)
Elevate growth hormone release
Hyperprolactinemia

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5
Q

L-Dopa- adverse effects/contraindications

A

ON-OFF PHENOMENA (END DOSE AKINESIA, FLUCTUATION IN RESPONSE)
Dyskinesia (tics, grimacing, bobbing)
Behavioral (organic brain syndrome- confusion, delirium; hallucinations, paranoia, mania, insomnia, anxiety, nightmares, depression)

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6
Q

L-Dopa- Drug Rxns

A

Hypertensive crisis when taken with MAO inhibitors (Phenelzine, but not Selegine)

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7
Q

Carbidopa- Mech of Action

A

DOPAMINE PERIPHERAL DEGRADATION INHIBITOR.

DOPA DEBARBOXYLASE INHIBITOR.

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8
Q

Carbidopa- Clinical Use

A

Given in combination
Parkinson’s (especially the bradykinesia)
Elevate growth hormone release
Hyperprolactinemia

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9
Q

Carbidopa- Adverse Effects/Contraindications

A

ON-OFF PHENOMENA (END DOSE AKINESIA, FLUCTUATION IN RESPONSE)
Dyskinesia (tics, grimacing, head bobbing)
Behavioral (organic brain syndrome- confusion, delirium)
hallucinations, paranoia, mania, insomnia, anxiety, nightmares, depression

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10
Q

Bromocriptine- Mech of Action

A

D2 AGONIST

PARTIAL D1 ANTAGONIST

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11
Q

Bromocriptine- Clinical Use

A

Parkinson’s

Hyperprolactinemia, pituitary adenoma

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12
Q

Bromocriptine- Adverse Effects/Contraindications

A

HYPOTENSION
ARRHYTHMIAS
DYSKINESIAS
PSYCHOLOGICAL DISTURBANCE (including increase in impulse control disorders- i.e. gambling)
anorexia, nausea, vomiting, colicky abdominal pain
less “on-off” phenomena

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13
Q

Ropinirol- Mech of Action

A

D2 AGONIST

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14
Q

Ropinirol- Clinical Use

A

Parkinson’s

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15
Q

Ropinirol- Notes

A

Newer drugs= more specific, longer half lives, less side effects

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16
Q

Ropinirol- Adverse Effects/Contraindications

A

Nausea

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17
Q

Pramipexole- Mech of Action

A

D3 Agonist

18
Q

Pramipexole- Clinical Use

A

Parkinson’s

19
Q

Amantadine- Mech of Action

A

RELEASE DA FROM TERMINALS

ANTI-VIRAL

20
Q

Amantadine- Clinical Use

A

Early Stage Parkinson’s

21
Q

Amantadine- Adverse Effects/Contraindications

A 
CNS effects 
restlessness
insomnia
inrritability
confusion
enhances anti-choinergic effects
22
Q

Selegaline, Rasgeline- Mech of Action

A

MAO-B INHIBITOR= DECREASED DA DEGRADATION

23
Q

Selegaline, Rasgeline- Clinical Use

A

Early stage Parkinson’s

later stages with L-DOPA to reduce “on-off” phenomena

24
Q

Selegaline, Rasgeline- Notes

A

metabolized to amphetamine (a DA and NE releaser and uptake inhibitor)

25
Q

Selegaline, Rasgeline- Drug Rxns

A

No hypertensive interaction with dietary tyramine

26
Q

Talcapone- Mech of Action

A

COMT INHIBITOR= DECREASED L-DOPA BREAKDOWN

27
Q

Talcapone- Clinical Use

A

Parkinson’s

28
Q

Talcapone- Adverse Effects/Contraindications

A

Liver toxicity

29
Q

Entacapone- Mech of Action

A

COMT INHIBITOR= DECREASED L-DOPA BREAKDOWN

30
Q

Entacapone- Clinical Use

A

Can be administered as a combo with Carbidopa and Levodopa for Parkinson’s

31
Q

Entacapone- Notes

A

improved “off-time” and motor scores

32
Q

Benztropine- Mech of Action

A

MUSCARINIC RECEPTOR ANTAGONIST

DECREASE EFFECT OF ACH WHOSE RELEASE WAS INCREASED BY REDUCTION OR LOSS OF INHIBITORY DA

33
Q

Benztropine- Clinical Use

A

Parkinson’s - Used early, especially in younger patients

Improve tremor and rigidity, but not bradykinesia

34
Q

Benztropine- Adverse Effects/Contraindications

A

cycloplegia
mydriasis
dry mouth
urinary retention

35
Q

Transplant tissue or stem cells- Clinical Use

A

Parkinson’s - not commonly used

36
Q

Deep Brain Stimulation- Mech of Action

A

STIMULATE THE SUBTHALAMIC NUCLEI OR INTERNAL GLOBUS PALLIDUS

37
Q

Deep Brain Stimulation- Clinical Use

A

Parkinson’s

38
Q

Pallidotomy- Mech of Action

A

UNILATERAL GLOBUS PALLIDUS LESION

39
Q

Pallidotomy- Clinical Use

A

Parkinson’s - Fallen out of favor

Relieves symptoms in the short term- causes issues in the long term

40
Q

Pallidotomy- Adverse Effects/Contraindications

A

Many side effects

Pharm II Test 2 (8 decks)

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