Parkinsons drugs Flashcards
What is the biological cause of Parkinsons?
Dopamine deficiency in the basal ganglia
What is the drug class of Selegiline and rasagiline?
Neuroprotective therapy for parkinsons
What is the mechanism of action of selegiline and rasagiline?
Selective inhibitor of MAO(b) in CNS. Inhibits breakdown of dopamine.
Which drug is metabolized to amphetamine and methamphetamine leading to insomnia?
Selegiline
What drug is given with L-DOPA to get it into circulation?
Carbidopa
What is the mechanism of action of carbidopa?
Inhibits DOPA decarboxylase in the gut preventing L-DOPA metabolism in the gut
What is the drug class of Tolcapone and Entacapone?
COMT inhibitors (CAPONEs)
What is the mechanism of action of tolcapone and entacapone?
Prolong L-DOPA and DA activity in CNS by preventing breakdown. MUST BE USED WITH L-DOPA
What are the dopamine agonists?
Bromocryptine, pramipexole, and ropinirole
When are the dopamine agonists used?
Early in parkinsons
What are the anticholinergics used to treat parkinsons?
trihexyphenidyl and benztropine
What is the mechanism of action of trihexyphenidyl and benztropine?
Muscarinic blockers
What is the drug class of amantadine?
An antiviral agent that can increase release of stored DA from presynaptic sites
What is the mechanism of action of amantadine?
Increases release of stored DA from presynaptic sites
What is the biological cause of Schizophrenia?
Abnormality in the DA system of the brain - too much produced or extrasensitive receptors
What is the high potency first generation antipsychotic drug?
Haloperidol
What are the low potency first generation antipsychotic drugs?
(AZINEs) Thioridazine, trifluoperazine, chlorpromazine
What are the atypical (newer) antipsychotics?
Aripiprazole, quetiapine, olanzapine, risperidone, iloperidone, paliperidone, lurasidone, ziprasodone, clozapine, loxapine, asenapine
What is the mechanism of action of the antpsychotic drugs?
Inhibit dopaminergic neurons - primary mechanism.
What is the biochemical basis of depression?
Depletion of CNS neurotransmitters (NE/5HT) [Amine hypothesis]
What are the first generation antidepressant drugs?
Tricyclic antidepressants (imipramine and amitriptyline) (1 TRIcycle IMpressed AMY with all it’s side effects)
What is the mechanism of action of imipramine/amitriptyline?
Inhibit NE reuptake
What are the side effects of imipramine/amitriptyline?
Can affect ACh, histamine neurons, sedation, anticholinergic effects (anti-muscarinic), blurred vision, dry mouth, cardiovascular effects (arrhythmias and decreased BP)
What are the second generation antidepressant drugs?
Fluoxetine, Citalopram, Escitalopram, Sertraline, Paroxetine (FLUzy CITy ESCorts had a SExy PARty)
What is the mechanism of action of the second generation antidepressant drugs?
Selective Serotonin reuptake inhibitor
What are the side effects of the SSRIs?
Nausea, diarrhea, insomnia, headache, decreased libido
What are the third generation antidepressant drugs?
Venlafaxine, duloxetine
What is the mechanism of action of the third generation antidepressant drugs?
Serotonin and Norepinephrine reuptake inhibitors (SNRIs)
What is the drug class of Phenelzine, isocarboxazid, and tranylcypromine?
Monoamine oxidase inhibitors
What is the mechanism of action of phenelzine, isocarboxazid, and tranylcypromine?
Monoamine oxidase inhibitors (which metabolizes NE and 5HT)
What are the side effects of Tranylcypromine, phenelzine, and isocarboxazid?
Insomnia, agitation, hallucination, seizure, liver toxicity, weight gain, hypotension
For what is Li+ used?
Prophylactic drug for treatment of Manic depression.
What is the mechanism of action of Li+?
Unclear, may stabilize glutamate system.
What are the side effects of Li+?
Low T.I. (<2) and Li+ retention is increased with diuretics
What are the side effects of lithium?
Short term: tremors, increased thirst/urine output, edema, weight gain, nystagmis; Long term: kidney damage, hypothyroidism; Toxic levels: nausea, delirium, coma
