Pharmacology of Parkinson's disease Flashcards
What is the mainstay of treatment for Parkinson’s disease? (Pharm)
State the trade name, ingredients, and the dosage.
L-DOPA and carbidopa, dose 500 to 1500 mg L-DOPA with 250 mg Carbidopa/day
L-DOPA remains by far the most important drug for treating Parkinson’s disease. Combined with the peripheral decarboxylase inhibitor carbidopa as Sinemet, L-DOPA provides useful clinical benefit for 5 to 20 years after diagnosis.
Name 2 dopamine receptor agonists.
Pramipexole
Ropinirole
[Bromocriptine]
Largely D2 agonists.
Name a drug that facilitates release of endogenous dopamine.
Amantadine
Also produces an NMDA block, presumably by acting as a glutamate antagonist.
[notes explicitly state “glutamate antagonist]
Name 3 anticholinergic drugs used in the treatment of Parkinson’s.
- Trihexyphenidyl
- Benzotropine
- Diphenhydramine
**Less used to to sfx
Name a MAO inhibitor used in the treatment of Parkinsons’s.
Selegiline.
Name 2 COMT inhibitors used in the treatment of Parkinson’s.
What does COMT stand for?
Entacapone
[Tolcapone]
Catechol-o-methyl transferase
Pramipexole
Dopamine receptor agonist.
Ropinirole
Dopamine receptor agonist.
Amantadine
Endogenous dopamine release, NMDA block
Trihexyphenidyl
Anticholinergic
Benztropine
Anticholinergic
Diphenhydramine
Anticholinergic
Selegiline
MAO-B inhibitor
Tolcapone
COMT inhibitor.
Entacapone
COMT inhibitor.
What is the average age of onset for Parkinson’s?
What are some environmental risk factors for Parkinson’s mentioned in lecture?
What are some protective factors mentioned in class?
Age 60. Younger onset is more likely to have a genetic underlying cause.
Well water, pesticides, copper/iron exposure are risk factors.
Coffee, tea, nicotine.
What do MAO inhibitors and COMT inhibitors do?
MAO - inhibit dopamine breakdown
COMT - inhibit L-dopa and dopamine breakdown
What are limiting side effects of anticholinergic agents?
Urinary retention, confusion, drowsiness, and constipation.
What are some surgical interventions for Parkinson’s?
DBS - insert into thalamus, GPi, Subthalamic nucleus.
Can surgically remove same structures, imagine this is less done now that DBS can perform the same function reversibly.
Fetal dopamine cell transplantation has also been tried.
What are the side effects of L-DOPA?
Long term - dyskinesias
Short term - nausea, hypotension, depression, psychosis
What is an important sfx of Dopamine receptor agonists?
Falling asleep (driving).
