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Clinical Neurosciences > Pharmacology of Movement disorders--Caldwell > Flashcards

Pharmacology of Movement disorders--Caldwell Flashcards

1
Q

what are the three dopaminergic pathways

A

nigrostriatal
mesolimbic
tuberinfundibular

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2
Q

treatment for off periods (akinesia)

A

Sub Q apomorphine (effect can be seen 10 minutes lasting up to 2 hours)

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3
Q

selective COMT inhibitors

A

entacopone and tolcapone

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4
Q

seletive irreversible inhibitor of MAO-B

A

selegiline

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5
Q

MOAB inhibitor

A

Rasagiline

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6
Q

what are the uses for selegiline

A

prolongs antiparkinsonism effect of L-dopa allowing for lower doses and may potentiate the adverse effects of L dopa

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7
Q

Mechanisms of action of rasagiline

A

more potent to prevent MPTP induced parkinsonism and is neuroprotective

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8
Q

MAO of tolcapone

A

reduces metabolism of L dopa to DA

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9
Q

adverse effect of entacopone

A

organge urine

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10
Q

adverse effects of tolcapone

A

lincreased liver toxicitiy

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11
Q

stalevo

A

L dopa
carbidopa
entacopone

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12
Q

anticholinergics drugs help what in PD patients

A

tremor and rigidity

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13
Q

what are the limitations to PD

A

less potent than L dopa

benefits are short lived and treatment only lasts a few weeks

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14
Q

what are four advantages of dopamine over L dopa

A

does NOT require enzymatic conversion
no toxic metabolites
do NOT compete with other substances to actively cross into the blood and the BBB
have fewer adverse side effects

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15
Q

indication for apomorphine

A

temporary relief of off periods of akinesia in patients on dopamine therapy

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16
Q

what beta blocker can be used to treat tremors

A

propanolol

17
Q

why cant metaprolol be used

A

need to act on B2 receptors and metaprolol acts on B1 receptors

18
Q

what are the neurons that die off in huntington disease

A

medium sized spiny GABA neurons in the basal ganglia

19
Q

mechanism of tetrabenazine

A

inhibits vesicular monoamine transporter 2 which is used for treatment of huntingtons diseasee

20
Q

drug approved for ALS

A

riluzole (protects motor neurons from toxic effects of excitatory amino acids)

21
Q

what is a class of drugs that is contraindicated with L dopa

A

antipsychotics–haloperidol and fluphenazine

22
Q

population of patients that should be careful with L dopa

A

psychotic patients, acute angle glaucoma, history of melanoma

23
Q

indication for selegiline

A

pro-longs antiparkinsonism effects

24
Q

indication of apomorphine

A

temporary relief of off periods of akinesia in patients on dopamine therapy

Clinical Neurosciences (16 decks)

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