Parkinsons Flashcards
dopamine is broken down by what 2 enzymes
MAO and COM-T
which pathway predominates in parkinsons
indirect
L-DOPA
only effective for 3-5 years
99% excreted as DA in urine
L-DOPA AE
GI, CV arrhythmias, Orthostatic HypoTN
L-DOPA CX in
Vit B6
MAOI - hypertensive crisis
L-Amino Acids - compete for absorption
Peptic ulcer, cardiac dz, melanoma
L-DOPA/carbinodopa
L-AAD inhibitor
cant cross BBB
-prolongs halflife, reduces ADE
ADE of L-DOPA/carbinodopa
behavioral abnormalities
dyskinesisas
bromocriptine
Dopamine receptor agonist
D2-agonist, D1-partial agonist
apomorphine
Dopamine receptor agonist
D1/D2-agonist
Pramipexole
Dopamine receptor agonist
D2 selective agonist
free radical scavenger
Ropinirole
Dopamine receptor agonist
D2 selective
CYP1A2 metabolism
Amatadine
antiviral
-inc. DA synth and release
dec. DA uptake
short lived
ADE of Amantadine
restlessness, depression, agitation, irritability, insomnia, excitement, hallucinations, confucision
CX: hx. of seizures or HF
Selegiline
MAOI
retards breakdown of DA
metabolites (meth) inc. DA release
Rasagiline
MAOI
more potent than other.
ADE of MAO-B-I
L-DOPA ADE
CXind: merperidine, TCAs, SSRIs
Entacapone
COMT inh.
protein bound
prefferred over other
only peripheral effects
Tolcapone
COMT inh.
protein bound
central and peripheral effects
hepatic problems
Benztropine
antimuscarininc - block cholinergic activation in striatum --> dec. gabaergic output of striatum ADE - CNS effects - Anti-cholinergic effects -CXind: prostatic hyperplasia
Diphenhydramine
antimuscarininc - block cholinergic activation in striatum --> dec. gabaergic output of striatum ADE - CNS effects - Anti-cholinergic effects -CXind: prostatic hyperplasia
Trihexyphenidyle
antimuscarininc - block cholinergic activation in striatum --> dec. gabaergic output of striatum ADE - CNS effects - Anti-cholinergic effects -CXind: prostatic hyperplasia
Reserpine
DA depleting agent for HD chorea
Tetraenazine
DA depleting agent for HD chorea
Chlorpromazine
D2-R antagonist HD
Haloperidol
D2-R antagonist HD