pharmacotherapy of movement disorders

Question 1

which drug used in replacement of DA?

Answer 1

L-dopa and L-doap/carbidopa

Question 2

name 4 dopamine receptor (D2) agonists?

Answer 2

bromocriptine - D2 agonist/ D1 partial agonist

apomorphine - D1/D2 agonist

Pramipexole - D2 selective, may also act as free radical scavenger

ropinirole - D2 selective, metabolized by CYP1A2

Question 3

drugs that inhibit DA metabolism iva MAO-B path? (2)

Answer 3

selegine

rasalagine

Question 4

drugs that inhibit DA metabolism via COMT?(2)

Answer 4

enacapone and tolcapone

Question 5

3 antimuscarinis used in tx of parkinsons

Answer 5

benztropine

diphenydramine

trihexyphenidyl

Question 6

what are the 2 VMAT inhibitors used in tx of Huntington’s disease? (DA depleting agents)?

waht are the 2 dopamine D2 receptor antagonists used in tx of huntington disease?

Answer 6

1. reserpine and tetrabenzamine
2. chlorpromazine and haloperidol

Question 7

what are the 4 main clinical features of Parkinsonianism? (4) TRAP

Answer 7

T- restint termor (abates during voluntary movements)

R- rigidity. muscular rigidity(increased muscle tone and increased resistance to movement)

A- Akinesia and bradykinesia ( slowness of movement)

P - postural instability and impaired gait

Question 8

what is the hallmark of parkinsonism and parkinson’s disease?

Answer 8

hall mark: selective losso f pigmented dopamine neurons(nueromelanini) is substantia nigra pars compacta.

Question 9

when do symptoms appear in Parkinson’s?

Answer 9

symptoms do not appear until striatal DA neuron levels decline by at least 70-80%

Question 10

obj: what are the five main strategies for PD pharmacotherapy?

Answer 10

1. replace DA
2. stimulate DA receptors
3. enchance DA release
4. inhibit DA metabolism
5. alter DA/acetylcholine balance

Question 11

drug that enchances DA release?

Answer 11

amantadine