Pharm 7 Anti-Parkinsons Flashcards
Amount of neurons lost needed for for Parkinson’s symptoms
60%
Parkinson’s effect on STN
Increased activation of STN
-Reserpine-
Deplete dopamine
Brain area of Dopamine depletion
Striatum (Putamen, Globus Pallidus)
-Carbidopa-
Inhibit peripheral decarboxylation of DA
L-Dopa side effects
“on-off” freezing
Peak dose grimacing & dyskinesia
Behavioral SE
Dementia
-Bromocriptine-
Indication
MOA
L-DOPA adjunct
D2 agonist, D1 antagonist
-Bromocriptine-
Metabolism
Liver
4-6h half life (short)
-Pergolide-
MOA
SE
D1 and D2 agonist
Heart valve regurgitation (withdrawn)
-Pramipexole-
Indication
MOA
Early mono-therapy
Also L-DOPA adjunct (reduce on-off effects)
D2 agonist
-Pramipexole-
Metabolism
Kidney
8-14h half life
-Ropinirole-
Indication
MOA
Early mono-therapy
L-DOPA adjunct
D2 agonist
-Ropinirole-
Metabolism
Liver
3-4h half life (short)
-Selegiline-
Indication
MOA
Early mono-therapy
L-DOPA adjunct
Improve cognitive functions
MAO-B inhibitor
-Selegiline-
Metabolism
Liver
1.5h half life (short)
-Selegiline-
Contraindications
TCA
SRI
(Serotonin syndrome)
-Tolcapone-
Indication
MOA
Late adjunct
Inhibit CNS & peripheral COMT
-Entacapone-
Indication
MOA
Late adjunct
Inhibit peripheral COMT
COMT inhibitor main use
Patients that develop “freezing”
Ameliorate peak dose dyskinesia
-Amantadine-
Indication
MOA
Early onset PD, heavy bradykinesia
Enhance DA levels
Anticholinergic
Anti-viral
NMDA antagonist
Drug eliciting orthostatic hypotension & cardiac arrhythmia SE
Bromocriptine
Drugs contraindicated with HTN
MAO B inhibitors
PD surgery
Deep Brain Stimulation of STN
Huntington’s chorea Tx
Reserpine
