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psych 1166 > Parkinsons > Flashcards

Parkinsons Flashcards

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1
Q

Dopamine blocking drugs that can worsen PD

4 total

A
  1. Prochloperazine
  2. Halopiridol
  3. Risperidone
  4. Metcopramide
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2
Q

Primary treatment of PD?

A

Replace dopamine

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3
Q

What is the preferred antipsychotic in PD?

A

Quitiapine due to the reduced risk of movement disorders

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4
Q

Preferred Drug treatment for PD?

A

Levodopa prodrug of dopamine most effective

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5
Q

What is given with levodopa and why?

A

Carbidopa prevents peripheral metabolism of levodopa

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6
Q

Why are dopamine agonists commonly given in PD?

A

Reduces off periods and limits dyskinisia (abnormal movements)

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7
Q

What is the dose of carbidopa that is needed to hibit dopa decarboxylase?

A

70-100 mg/day

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8
Q

Sinemet or Sinemet CR

A

Levo/carbidopa

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9
Q

Notes about Sinemet?

A

CR tab can be cut in half but dont crush or chew

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10
Q

4 SEs of Sinemet?

A
  1. Nausea
  2. Dizziness
  3. Orthostatis
  4. Dyskinesia
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11
Q

Sinemet can cause what?

A

Brown black or dark urine

Positive combs test discontinue: hemolysis

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12
Q

What do COMT inhibitors do?

A

Increase duration of action of levodopa

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13
Q

Dosing of COMT inhibitors?

A

200 mg PO with each levo/carbi dose

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14
Q

2 dopamine agonists used in PD?

A

Pramipexole

Ropinorole

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15
Q

Neupro?

A

Rotigotine patch

dopamine agonists

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16
Q

Neupro patch instructions?

A

Apply once daily dont use the same spot for at least 14 days

remove before MRI

aovid if allergic to sulfites

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17
Q

Apomorphine contra?

A

DOnt used with 5HT3s severe hypotension

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18
Q

How is the apomorphine dose written?

A

mL not mg

19
Q

Contraindications to SInemet?

A

Dont use with non-selective MAOs

Iron and protein rich food decrease absoprtion

20
Q

Selective MAO B inhibitors?

A

Selegiline

21
Q

COntaindications to MAO B

A

COmbo with other MAOs including other MAOs linezolid, opioids, SNRIs,

Xadago severe hepatic impairment

22
Q

2 warnigns for MAO Bs?

A

Serotonin syndrome

HTN

23
Q

WHen should selegiline be taken?

A

Can be activating dont take at night

24
Q

Cogentin?

A

Benztropine

Central acting anticholinergic

25
Q

What score on the MMSE is considered a memory disorder?

A

<24

26
Q

What can cause acute memory impairment?

A

Centrally acting anticholinergics

27
Q

What vitamin has shown some benefit for alzheimerz?

A

VIt E

28
Q

Gingko?

A

Also thought to help memory but increases bleeding risk

29
Q

8 drugs that can worsen dementia?

A
  1. Antihistmines, antiemetics
  2. Antipyschotics
  3. barbiturates
  4. BZDs
  5. Central acting anticholnergics benztropine
  6. Peripheral anticholinergics oxybutynin
  7. Skeleta muscle relaxants
  8. Other CNS depressants
30
Q

What is used for pharmacotherapy in dementia?

A

Acetylcholenesterases

donepezil used alone or with memantine for severe stages

31
Q

What is donepezil taken?

A

Can cause nausea taken at night for that reasons

If insomonia is present can take in the morning if issue

32
Q

Namzaric?

A

Donepezil/Memantine

Pts stablaized with 10 mg donepezil can switch to combo

`

33
Q

Namenda?

A

Memantine

can be used alone or in combo with donepezil

34
Q

Aricept?

A

Donepezil

35
Q

What do acetylcholinesterases inhibitors do?

A

inhibit central active acetylcholinesterase

this cause an increase in acetylcholine

36
Q

Warning for Aricept?

A

Bradycardia

37
Q

SEs of Aricept?

A

Insomnia and Nausea

38
Q

What AcH formulations do what?

A

Exelon patch and donepezil ODT have less GI SEs

39
Q

ER capsules or Namzaric?

A

Do not crush or chew but can be opened and sprinkled on applesauce

40
Q

Caution for acetylcholinesterase Inhibitors?

A

Caution with other drugs that lower HR and with other drugs that can cause dizziness

Drugs that have anticholinergic effects can reduce efficacy of these drugs

41
Q

Exelon

A

Rivastigmine

42
Q

Exelon patch use instructions?

A

Saem time each day to the upper or lower back, or upper arm or chest

rotate sites

43
Q
A

psych 1166 (20 decks)

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