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Boards Prep > Pharmacology of Drugs for Neurodegenerative Disorders > Flashcards

Pharmacology of Drugs for Neurodegenerative Disorders Flashcards

1
Q

What anticholinergic drugs are used to treat Parkinson’s?

A

Benztropine, trihexyphenidyl

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2
Q

What life-threatening ADRs are associated with use of MOA inhibitors?

A

Hypertensive crisis and serotonin syndrome in patients on TCAs or SSRIs

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3
Q

What is the primary strategy for the use of drugs to treat Parkinson’s disease?

A

In Parkinson’s disease, less dopamine is present in the synaptic cleft. The target of drugs is to increase or amplify functional dopamine

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4
Q

What is the MOA of Selegiline?

A

A selective, irreversible inhibitor of MOA-B. This drug cannot be used as a monotherapy

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5
Q

Amantadine should be used cautiously in what patient populations?

A

Patients with seizures, heart failure, or renal failure

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6
Q

This drug is a dopamine precursor the works to increase the presence of dopamine at the synaptic cleft.

A

Levodopa

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7
Q

What is the MOA of Riluzole?

A

Antioxidant that reduces glutamate-induced excitotoxicity of ALS

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8
Q

What antipsychotic does not target D2 receptors and may be used to treat psychosis in a patient with Parkinson’s disease?

A

Primavanserin

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9
Q

Hallucinations are associated with what MOA inhibitor?

A

Selegiline

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10
Q

What are the COMT inhibitors used to treat Parkinson’s?

A

Entacapone & Tolcapone

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11
Q

What is the MOA of Lecanemab?

A

Monoclonal antibody against amyloid beta plaques

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12
Q

What is the MOA of anticholinergic medications in treating Parkinson’s?

A

Dampen stimulatory signaling from neurons

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13
Q

What is the most common dopamine agonist used to treat Parkinson’s disease?

A

Pramipexole

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14
Q

Impulse control disorders are associated with what MOA inhibitor?

A

Rasagiline

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15
Q

What is the only drug used to treat Alzheimer’s that reduces the rate of disease progression and slows cognitive decline?

A

Lecanemab

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16
Q

Levodopa is quickly converted to dopamine in circulation and cannot cross the BBB. How can this issue be resolved?

A

Co-treatment with a DOPA decarboxylase inhibitor. L-DOPA can cross the BBB, where there it can be converted to dopamine by a DOPA decarboxylase

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17
Q

Symptoms of parkinsonism induced by drugs typically resolve within 6 months of drug withdrawal. What drug is the exception?

A

Synthetic heroin (MPTP) - symptoms are irreversible and progressive degeneration of neurons may occur for years

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18
Q

What drug is used as a rescue therapy for temporary relief of off-periods of akinesia?

A

Apomorphine

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19
Q

These categories of Parkinson’s drugs work to prevent the breakdown of dopamine.

A

DOPA decarboxylase inhibitors, Catechol-O-methyltransferase inhibitors (COMTIs), Monoamine oxidase B inhibitors (MOA inhibitors)

20
Q

What is the MOA of tetrabenazine?

A

Depletes cerebral dopamine to reduce severity of chorea

21
Q

True/False. Levodopa may be used as a chronic monotherapy to treat motor symptoms of Parkinson’s disease.

A

False. The benefits of Levodopa begin to decline after 3-5 years. Other drugs may be added to enhance the effects of Levodopa, but decreased efficacy and response fluctuations will occur

22
Q

What serious ADR is associated with monoclonal antibody treatment of Alzheimer’s?

A

Intracerebral hemorrhages

23
Q

True/False. A patient failed treatment with L-dopa. Treatment with Pramipexole is an effective next treatment option.

A

False. Dopamine agonists are generally ineffective in patients who did not respond to L-dopa.

24
Q

What NMDA Antagonist is used to improve cognition in patients with early Alzheimer’s?

A

Memantine

25
Q

Anticholinergics should not be used to treat Parkinson’s in what patients?

A

Elderly and cognitively impaired, patients with bradykinesia

26
Q

What are the contraindications for the use of L-dopa?

A

Closed-angle glaucoma, psychosis, melanoma or undiagnosed skin lesions, cardiac disease, gastric ulcer

27
Q

What DOPA decarboxylase inhibitor is typically administered with Levodopa?

A

Carbidopa (Benserazide is another inhibitor)

28
Q

What are the stages of treatment with Levodopa?

A

Honeymoon phase (dramatic improvement), benign fluctuations in response (wearing-off reactions, end-of-dose akinesia), unpredictable response fuctuations

29
Q

What is the MOA of Amantadine?

A

NMDA receptor antagonist that potentiates dopaminergic effects

30
Q

What is the MOA of donepezil, rivastigmine, and galantamine in treating Alzheimer’s?

A

Cholinesterase inhibitors that enhance cholinergic functioning in the basal forebrain for cognition and functioning

31
Q

What MOA inhibitor is a selective, irreversible inhibitor of MOA-B, but may be administered as a monotherapy in early Parkinson’s treatment.

A

Rasagiline. Selegiline is also an irreversible, selective MOA-B inhibitor, but is always used as an adjunct therapy

32
Q

What drugs are known to interact with L-dopa?

A

Vitamin B6, antiemetics, antipsychotics, MAO-A inhibitors

33
Q

What ADRs are associated with L-dopa?

A

Dyskinesias (especially twitching of face and extremities), GI disturbances, cardiac arrhythmias, orthostatic hypotension, depression, anxiety, confusion, and psychosis

34
Q

What is the only Parkinson’s medication that can be used as short-term treatment for bradykinesia, rigidity, and tremor?

A

Amantadine

35
Q

What drug is used to treat ALS?

A

Riluzole

36
Q

What drugs are known to induce Parkinsonism?

A

Antipsychotics, antiemetics, synthetic heroin (MPTP)

37
Q

What ADRs are associated with COMT inhibitors?

A

Dyskinesias, GI disturbances, confusion, orthostatic hypertension, urine discoloration

38
Q

What COMT inhibitor is most commonly used, even though it is less effective?

A

Entacapone - Tolcapone is more effective but has high risk of hepatotoxicity

39
Q

What drug is used to reduce movement in patients with Huntington’s Disease?

A

Tetrabenazine

40
Q

What is the oral form of Riluzole for ALS treatment?

A

Edaravone

41
Q

ADRs of dopamine agonists are similar to those of L-dopa. What additional ADRs are present?

A

Dopamine agonists withdrawal syndrome, dopaminergic dysregulation syndrome, sleep attacks

42
Q

True/False. L-dopa, dopa decarboxylase inhibitors, and COMT inhibitors may all be administered to treat Parkinson’s and work to increase dopamine presence.

A

True. The combined drug is called Stalevo. This is commonly useful when patients reach the phase of response fluctuations with L-dopa alone

43
Q

What ADRs are most commonly associated with cholinesterase inhibitors in treating Alzheimer’s?

A

GI disturbances, bradycardia, hypotension, sleep distubrances

44
Q

Dopamine agonists are contraindicated in what patients?

A

Patients with history of psychosis, myocardial infarction, peptic ulcers

45
Q

Parkinson’s disease is characterized by demyelination of neurons in the substantia nigra. Where do these neurons project?

A

Striatum (Caudate & Putamen)

46
Q

Riluzole and Edaravone have limited effects on the disease progression of ALS. What drugs are used solely for symptomatic treat of ALS?

A

Baclofen (spasticity) & Gabapentin (slow muscle atrophy)

47
Q

Peripheral edema and livedo reticularis are ADRs associated with what Parkinson’s medication?

A

Amantadine

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