parkinsons, alzheimers, hypo/hyperthyroidism Flashcards
what neurotransmitter is linked to Parkinson’s Disease?
Dopamine
Can someone be given straight dopamine?
yes, through IV only.
Why do we not use Dopamine as a treatment for Parkinson’s?
It can not cross the blood brain barrier so it wont work
What Drug is the cornerstone for Parkinsons?
Levodopa
What drug is Levodopa always given with?
Carbidopa
Why is Levodopa always given with Carbidopa?
Carbidopa protects levodopa from being converted to dopamine outside of the brain.
What is foods affect on levodopa?
it can delay absorption
What kind of diet will compete levodopa for amino acids?
Protein
What is a big adverse effect with levodopa?
Dyskinesia
Dyskinesia
involuntary muscle movements
Dopamine agonists
Pramipexole & Ropinirole
What disorder can Dopamine agonists cause?
Impulse control disorder
Anticholinergic agents
benztropine
When are anticholinergic agents most useful?
in combination with levodopa
Adverse effects of anticholinergic agents?
drowsiness, trouble focusing, confusion, delusions and MEMORY PROBLEMS
Alzheimers Disease
leading cause of dementia
low acetycholine in the brain
Cholinesterase inhibitor
Donepezil
Why do you avoid abrupt discontinuation of Donepezil?
It causes acute impairment in cognition and behavioral problems
What is the purpose of Alzheimer meds?
they will slow the progression of dementia but will not reverse it
Memantine
blocks glutamate
can be used with donepezil
What can too much glutamate cause?
neurotoxicity
Hypothyroidism
low thyroid hormones
What are the 3 thyroid hormones
TSH, T3 and T4
Is T3 or T4 more active?
T3
Symptoms of hypothyroidism
lethargy, cold, dry skin, hair loss and high cholesterol
What are T3 and T4 for?
energy use, cardiac activity, growth and development
Levothyroxine
can be oral and injectable; used for hypothyroidism
What are the rules with taking levothyroxine with food?
take on an empty stomach; 30-60 minutes before breakfast, evening : 3-4 hours after last meal
Why is generic substitution controversial with levothyroxine?
The generics only have to be with in 80% (or higher) with the amount that will be in the blood stream as the brand name. This dose is so specific they want it to be consistent but with all the different manufacturers it is hard
What do Brand name drugs have to prove?
relatively safe and effective
What do generic drugs have to prove?
that 10mg of this generic is equivalent to 10mg of the brand drug dissolving. (with in 80% or higher)
Armour Thyroid
mix of T3 and T4 like how the body would create it; treats hypothyroidism
What is armour thyroid made of?
dried animal thyroid glands
Hyperhtyroidism
Methimazole
treats hyperthyroidism, blocks T3 and T4
how long can you give methimazole?
12-18 months
How many people relapse after methimazole?
30-70
Adverse effects of methimazole
Agranulocytosis- medical emergency
hepatitis, hepatic failure
When should you not take methimazole?
The 1st trimester of pregnancy
