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NMSP Exam 2 > Pharm: Movement Disorders - Kruse > Flashcards

Pharm: Movement Disorders - Kruse Flashcards

1
Q

apomorphine

A

DA agonist

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2
Q

bromocriptine

A

DA agonist

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3
Q

pramipexole

A

DA agonist

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4
Q

ropinirole

A

DA agonist

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5
Q

rasagiline

A

MAOI

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6
Q

selegiline

A

MAOI

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7
Q

safinamide

A

MAOI

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8
Q

entacapone

A

catehol-O-methyltransferase inhibitor

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9
Q

tolcapone

A

catechol-O-methyltransferase inhibitor

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10
Q

benztropine

A

anticholinergic

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11
Q

biperiden

A

anticholinergic

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12
Q

orphenadrine

A

anticholinergic

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13
Q

procyclidine

A

anticholinergic

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14
Q

trihexyphenidyl

A

anticholiergic

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15
Q

riluzole

A

misc agent

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16
Q

reserpine, tetrabenazine

A

misc agents

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17
Q

what med agents can be used for pts with PD?

A

DA agonists and/or anticholinergics

18
Q

immediate metabolic precursor to DA, 1-3 hr half life

  • approved for the use in Parkinsonian syndrome
  • hallmark side effect is development of dyskinesia (distortion/impairment of voluntary movement)
A

levodopa

19
Q

what are the adverse effects of levodopa?

A
  1. GI: N/V
  2. CV: postural hypotension, or HTN
  3. dyskinesias occur in 80% of pts (choreoathetosis of face and distal extremities)
  4. behavioral: depression, anxiety, agitation, insomnia, somnolence, confusion
  5. fluctuations in response, on/off phenomenon: periods of marked akinesia alternate over the course of a few hours with periods of improved mobility
20
Q

what drug class can be administered in addition to levodopa/carbidopa, and those who have end-of-dose akinesia or on/off phenomenon?

A

DA receptor agonists

21
Q

which DA agonist have extensive first pass metabolism with CYP34?

A

bromocriptine

22
Q

which DA agonist has preferential affinity for D3 receptors, and is approved from treatment of moderate-severe restless leg syndrome

A

pramipexole

23
Q

which DA agonist may require as dose adjustment in pts with renal insufficiency

A

pramipexole - KNOW this

24
Q

which DA agonist has preferential affinity for D2 receptors, and is metabolized primarily by CYP1A2?

A

ropinirole

25
Q

what are the adverse effects of DA agonists?

A
  1. GI: anorexia, N/V, constipation
  2. CV: postural hypotension
  3. dyskinesias
  4. mental disturbances: confusion, hallucination, delusions
26
Q

what are the contraindications of DA agonists?

A

pts with hx of PSYCHOTIC ILLNESS, RECENT MI, OR ACTIVE PEPTIC ULCERTATION

27
Q

what does MAO-A preferentially metabolize?

A

NE and 5HT

28
Q

what does MAO-B preferentially metabolize?

A

phenylethylamine and benzylamine

29
Q

what are equally metabolized by MAO-A and B?

A

DA and tryptamine

30
Q

which MAO-I is a selective irreversible MAO-B inhibitor?

A

selegiline

31
Q

what is the precaution with MAO-I’s?

A
  • pts taking meperidine, TCA’s, or SSRI’s -> RISK OF SEROTONIN SYNDROME
  • also, do NOT combine levodopa and nonselective MAO-I treatment -> RISK OF HYPERTENSIVE CRISIS
32
Q

these meds prolong the activity of levodopa by inhibiting peripheral metabolism, which decreases clearance and increases bioavalability

A

catechol-O-methyltransferase (COMT) inhibitors

- tolcapone, entacapone

33
Q

DA agonist at D2 receptors

- injected subQ -> clinical benefits in 10 mins!

A

apomorphine

SA’s: nausea, dyskinesias, drowsiness, sweating, hypotension, injection site bruising

34
Q

antiviral agent whose MOA in parkinsonism in unknown
- may cause livedo reticularis (vascular condition w/purplish mottled discoloration of the skin, usually the legs); restlessness, depression, irritability, hallucinations, insomnia, HA, heart failure

A

amantadine

35
Q

what drug class may improve tremor and rigidity in PD, but have little effect on bradykinesia?

A

anticholinergic drugs

- adverse effects: common peripheral anchicolinergic effects)

36
Q

what drugs used to treat:

- tremor

A
  • metoprolol, propranolol
  • topirimate
  • alprazolam
  • botulinum toxin A
37
Q

what drugs used to treat:

- HD

A

no current therapy slows disease progression

- but reserpine and tetrabenazine can alleviate chorea

38
Q

what drugs used to treat:

- tics

A
  • tetrabenazine, haloperidol, pimozide -> EPS :(

- clonidine, guanfacine (effective w/fewer adverse effects)

39
Q

what drugs used to treat:

- restless leg syndrome

A
  • pramipexole, ropinirole

- gabapentin, pregabalin (a2-Ca channel ligands)

40
Q

what drugs used to treat:

- ALS

A

riluzole (only drug w/impact on survival)

- inhibits glutamate release and blocks NMDA-r, inhibiting voltage-gated Na channel

41
Q

what drugs used to treat:

- Wilson disease

A
  1. penicillamine (chelating agent, surrounds copper)
  2. potassium disulfide (reduces intestinal absorption of copper)
  3. trientine, zinc acetate, zinc sulfate (increase fecal excretion)

NMSP Exam 2 (13 decks)

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