Parksinonism and MvmtDisorders Flashcards
Q
A
Clinical response that may fluctuate in tx of Parkinson’s dx
“On-off-phenomenon”
Enhances dopaminergic neurotransmission SE’s include CNS excitation, acute toxic psychosis and livedo reticularis
Amantadine
Agent decreases the excitatory actions of cholinergic neurons. May improve tremor and rigidity but have LITTLE effect on bradykinesia. Atropine-like side effects
Benztropine
Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia
Bromocriptine
This is combined with L-dopa, inhibits DOPA decarboxylase (active only peripherally) which allows lower effective doses of L-dopa and allows for fewer SE’s (GI distress, postural hypotension, and dyskinesias)
Carbidopa
Antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible
Drug induced Parkinsonism
Inhibitors of catechol-O-methyltransferase (COMT), used as adjuncts in Parkinson’s dx and cause acute hepatic failure (monitor LFT’s)
Entacapone and Tolcapone
Agents used in Tourette’s dx
Haloperidol or pimozide
Agent used in drug therapy of Parkinson’s instead of Dopamine which has low bioavailability and does not cross the BBB
L-dopa
Anti-Parkinson’s drug which increases intraocular pressure and is contraindicated in closed angle glaucoma
Levodopa
Chelating agent used in Wilson’s disease
Penicillamine
Non ergot agents used as first-line therapy in the initial management of Parkinson’s
Pramipexole and ropinirole
Agent effective in physiologic and essential tremor
Propranolol
Inhibitor of MAO type B which metabolizes dopamine, used adjunct to levodopa or as sole agent in newly diagnosed pt’s
Selegiline
