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pharm > pharm antiparkinsonian drugs > Flashcards

pharm antiparkinsonian drugs Flashcards

1
Q

parkinsons

A

progressive neurodegenerative disease

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2
Q

parkinsons affects

A

dopamine-producing neurons by having an imbalance of dopamine and ACh

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3
Q

symptoms occur when

A

80% of dopamine stored in basal ganglia is depleted

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4
Q

symptoms can be controlled when

A

nerve terminals can uptake dopamine

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5
Q

parkinsons symptoms include

A

bradykinesia (slow movement)
TRAP- tremor, rigidity, akinesia, postural instability.

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6
Q

dyskinesia

A

difficulty preforming voluntary movements.
when too much dopamine is present

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7
Q

2 types of dyskinesia

A

chorea- spasmodic movement in face or limbs
dystonia- abnormal muscle tone leading to abnormal movements

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8
Q

drug therapies aimed at

A

increasing levels of dopamine and antagonizing ACh

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9
Q

levdopa

A

precursor for dopamine, allowed in blood-brain barrier (unlike dopamine).

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10
Q

nondopamine dopamine receptor agonist ex

A

ergot derivative- bromocriptine

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11
Q

bromocriptine

A

works by direct stimulation of presynaptic receptors in brain. stim production of dopmine in brain and inhibits production of proalctin

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12
Q

bromocriptine adverse effects + use with caution

A

use with caution with ppl w/ peripheral vascular disease
GI upset, dyskinesias, sleep disturbances

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13
Q

bromocriptine drug interactions

A

erythromycin and adrenergic drugs

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14
Q

levodopa is a ____ drug

A

replacement

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15
Q

levodopa action

A

works presynaptically to increase blood levels of dopamine

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16
Q

___ is given with levodopa

A

carbidopia

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17
Q

carbdopia action

A

binds with levodopa, doesnt cross blood brain barrier, helps prevent breakdown in periphery. results in more levodopa in bb barier

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18
Q

levodopa uptake route

A

taken up by the dopaminergic terminal and converted into dopamine and then neurotransmitter imbalance is controlled.

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19
Q

after 5-10 years of levodopa therapy…

A

terminals dont work as good, levodopa is not as effective

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20
Q

levodopa adverse effects

A

confusion, involuntary mvmt, GI distress, hypotension, cardiac arrythmias

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21
Q

levodopa-carbidopa is counterindicated in cases of

A

angle closure glaucoma

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22
Q

use levodopa-carbidopa with caution when person has

A

open angle glaucoma

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23
Q

levodopa-carb interactions

A

pyridoxine, nonselective MAOIs, benzodiazepines, antipsychotics, dietary protein

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24
Q

carbidopa alone

A

treats nausea associated with sinemet

25
Q

sinemet CR

A

controlled release.
increase on time and decrease off time

26
Q

carbidopa levodopa is best taken__

A

on an empty stomach

27
Q

selective monoamine oxidase inhibitor therapy

A

inhibit the break down of catecholamines in CNS

28
Q

selective MAO -B inhibitor exs

A

selegiline hydrochloride and rasagiline mesylate

29
Q

selective MAO -B inhibitors action

A

inhibit breakdown of catechlomides

30
Q

cheese effect

A

MAO-A interact with cheese, results in hypertension

31
Q

rasagiline and selegiline are used with

A

used as adjuncts with levodopa

32
Q

rasagiline and selegiline are used with

A

use with meperidine (opiate)

33
Q

dopamine modulator ex

A

amantadine hcl
- antiviral used to treat influenza
-indirect
-release dopamine and catechlomides from presynaptic

34
Q

amantadine hcl blocks….

A

blocks reuptake of dopamine into the nerve fibers

35
Q

amantadine is used (when and how long) ____

A

early in the course of the disease for 6-12 months

36
Q

anamtadine is used to treat____

A

dyskinesia assicoated with carbidopa- levodopa

37
Q

amantadine adverse effects

A

mild. dizziness, insomnia, nausea

38
Q

amantadine drug interactions

A

increased anticholinergic adverse effects when given with anticholinergic drugs

39
Q

COMT inhibitor ex and MOA

A

entacapone
-block COMT (blocks enzyme that breaks down catechlomides)

40
Q

entacapone prolongs ______

A

duration of action of levodopa

41
Q

entacapone adverse effects

A

GI upset, urine discoloration, worsen dyskinesea

42
Q

anticholinergic therapy

A

anticholinergics blocks the effects of ACh

43
Q

anticholinergics are used to treat _____

A

muscle tremors and muscle rigidity

44
Q

anticholinergics doesnt relieve ____

A

bradykinesia (slow movements)

45
Q

ACh is responsible for causing SLUDGE

A

salivation, lacrimation, urinating, diarrhea, GI motility and emesis

46
Q

anticholinergics have ____ effect

A

opposite (dry SLUDGE)

47
Q

benztropine mesylate

A

antichol drug used for PD and extrapyramidal symptoms form antipsychotic drugs

48
Q

benzotropine caution

A

use caution with hot weather, may cause hyperthermia

49
Q

benztropine adverse effects

A

tachycardia, confusion, disorientation, urinary retention, N and V

50
Q

what should you avoid when taking benztropine mesylate

A

alc

51
Q

what kinds of questions to ask when performing hh

A

CNS, GI tract, phys and emotional status

52
Q

signs and symptoms of PD

A

masklike expression, speech prob, dysphagia, shuffling gait

53
Q

taking levodopa with MAOIs can cause

A

a hypertensive crisis

54
Q

can you discontinue antiparkisonians suddenly

A

naur

55
Q

what drug can darken pts urine and sweat

A

entercapone

56
Q

therapeutic effects of COMP inhibitor can take

A

a few days

57
Q

positive results of drug therapy

A

imroved mental status, increased appitite, less parkinsons symptoms

58
Q
A
59
Q
A

pharm (21 decks)

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