Parkinsons Disease Flashcards
What neurons die in Parkinsons disease?
What drugs worsen PD?
What the TRAP major symptoms of PD?
Neurons in the substantia nigra.
Prochlorperazine, Phenothiazines, Haloperidol, Risperidone, Metoclopramide.
Tremor, Rigidity, Akinesia/bradykinesia, postural instability.
Why is carbidopa given with levodopa?
What to know about Carbidopa/levodopa MOA and names?
What to know about side effects and dosing of Sinemet?
To prevent the peripheral metabolism of levodopa.
Levodopa is a precursor of dopamine. Carbidopa inhibits dopa decarboxylase enzyme which prevents peripheral metabolism of levodopa. Sinemet, Sinemet CR.
CR tab can be cut in half, 70-100mg/day of carbidopa required, titrate cautiously and take whole or sprinkle. Nausea, dizziness, orthostasis, dyskinesias, can cause brown, black or dark urine, Coombs test:discontinue drug(hemolysis risk), unusual sexual urges, priapism, long term use can lead to fluctuations in response and dyskinesias. CI’d with non selective MAOIs.
How does Entacapone (comtan) work and how do you dose it?
How does pramipexole and ropinirole work and what to know about them and brand names?
What to know about Apomorphine (Apokyn)?
Increases duration of action of levodopa, inhibits COMT(catechol-o-methyltransferase). 200 mg PO with each dose.
Dopamine agonist at receptor, Mirapex and Mirapex er are Pramipexole, Requip and Requip XL are Ropinirole. Somnolence, sudden daytime sleep attacks, orthostasis, hallucinations, dyskinesias, application site skin for Rotigotine(neupro) patch. Apply patch once daily, do not use same site for at least 14 days, remove the patch before an MRI and avoid if allergic to sulfites.
Injection, rescue movement agent for off periods. Do not use with 5HT3 antagonists, Severe hypotension and loss of consciousness, Severe N/V and hypotensions, caution, dose written in mL not MG/ Emesis prevention is give trimethobenzamide.
What does amantadine do and what to know about it?
What are the Selective MAO-B inhibitors and what to know about them?
How does benztropine work and what to know about it?
Blocks dopamine reuptake, somnolence, psychosis, dizziness, orthostatic hypotension.
Block the breakdown of dopamine, Selegline, Rasagiline, Safinamide. Selegiline can be activating, do not take at bedtime. Use in combination with other MAOI(including linezolid), opioids, SNRI, Xadago (safinamide) has severe hepatic impairment. Serotonin syndrome, hypertension. Avoid foods high in tyramine
Centrally acting Anticholinergic, Cogentin, dry mouth, constipation, urinary retention, blurred vision, somnolence, confusion
What to know about Droxidopa (Northera)?
Syncope,Falls,HA is the side effects.Alpha/beta agonist used for neurogenic orthostatic hypotension.
