PPT Flashcards
first line Tx Parkinson’s when motor Sx affecting pt’s QOL?
levodopa
first line Tx Parkinson’s when motor Sx are not affecting pt’s QOL?
dopamine agonist, levodopa or MAO-Bi
which anti-parkinsons drugs cause the most improvement in motor Sx?
levodopa
which anti-parkinsons drugs cause the most improvement in ADLs?
levodopa
which anti-parkinsons drugs cause the most motor complictions?
levodopa
which anti-parkinsons drugs have more off-time reaction?
dopamine agonists
which Parkinson’s drugs are the highest risk o hallucination?
dopamine agonists
which pts are more at risk of impulse control disorders?
dopamine agonist therapy
a history of previous impulsive behaviours
a history of alcohol consumption and/or smoking
which drug can be considered if excessive daytime sleepiness develops secondary to Parkinson drugs?
modafinil
which drug can be considered if orthostatic hypotension develops secondary to Parkinson’s drugs?
midodrine
what can be considered to manage drooling of saliva in people with Parkinson’s disease?
glycopyrronium bromide
what are the 2 common types of levodopa given?
carbidopa or benserazide (co-benldopa and co-careldopa)
wha is levodopa always combined with and why?
nearly always combined with a decarboxylase inhibitor (e.g. carbidopa or benserazide)
this prevents the peripheral metabolism of levodopa to dopamine outside of the brain and hence can reduce side effects
common adverse effects of levodopa
dry mouth
anorexia, N&V
reddish discolouration of urine upon standing
palpitations
postural hypotension
psychosis
end-of-dose wearing off
on-off phenomenon
dyskinesias at peak dose
examples of dopamine receptor agonists used for parknsons
bromocriptine, ropinirole, cabergoline, pramipexole
SE of dopamine agonists?
impulse control disorders
excessive daytime somnolence
halluinations
nasal congestion
postural hypotension
examples of COMTi?
entacapone, tolcapone
example of MAO-Bi?
selegiline
rasagiline
MOA sodium valproate?
increase GAB activity
MOA carbamazepine?
Binds to sodium channels increasing their refractory period
moa lamotrigine?
sodium channel blocker
moa of phenytoin?
Binds to sodium channels increasing their refractory period
moa of orphendrine?
antimuscarinic
moa of vigabatrin?
GABA transaminase inhibitor
moa of gabapentin?
gaba analogue
moa of pregabalin
gaba analogue
moa of topiramate?
glutamate receptor antagonist
moa of ethosucimide?
neuronal calcium channel block
moa of triptans?
serotonin 5HT1B/1D agonist
moa of donopezil?
selective reversible inhibitor of acetylcholinesterase
moa of galantamine
selective reversible inhibitor of acetylcholinesterase
moa of rivastigmine
selective reversible inhibitor of acetylcholinesterase
moa of memantine
NMDA receptor antagonist
what do levodopa interact with?
MAOi
general anaesthetics
antihypertensives
liquid calculation
(what you want / what youve got) x volume its in
what does 1 in 1000 mean?
1 in 1000ml
