Strictly Drugs (Parkinson's disease) Flashcards
benztropine [Cogentin]
ANTICHOLINERGIC
benztropine [Cogentin] benztropine, benztropine, benz-tro-pine benztropine suppresses tremor and rigidity benztropine comes PO, IM, IV benztropine side effects drowsiness, confusion, constipation, nausea and vomiting blurred vision mydriasis photophobia, dry skin urinary retention decreased sweating
OVERDOSE of benztropine
respiratory depression
circulatory collapse
shock,
coma
the antidote to benztropine:
PHYSOTIGMINE
trihexyphenidyl [Artane]
ANTICHOLINERGIC
trihexyphenidyl is the same as benztropine
in older males, may cause prostatic hyperplasia
ATROPINE
used a lot in emergency hospital settings.
overdose causes respiratory depression,
circulatory collapse, shock, and coma
antidote fore atropine PHYSOTIGMINE
evodopa [L-dopa]
DOPAMINE INCREASERS
saved until the end after the others have stopped working.
small percentage crosses the BBB intact.
decarboxylated to dopamine, thus replacing missing brain
dopamine and balancing dopamine-acetylcholine concentrations
takes 2-3 weeks to get the effect, sometimes longer.
SIDE EFFECTS OF LEVODOPA
anxiety, nervousness, confusion,
NIGHTMARES, tremors, involuntary movements,
INSOMNIA, DYSTONIAS (head bobbing, jerking movements,
DARK URINE
levodopa-carbidopa [Sinemet]
DOPAMINE INCREASER
the nurse will see this or L-dopa most often.
carbidopa is a decarboxylase inhibitor.
competes with the enzyme dopa decarboxylase
retards the peripheral breakdown of l-dopa
minimizes nausea and vomiting.
carbidopa does not cross the BBB
does not interfere with the intracerebral transformation of l-dopa to dopamine
because of peripheral action there are less side effects
combining the 2 drugs allows the use of much lower doses of l-dopa
because more l-dopa gets to the brain, you will get more cns side effects
like involuntary movements, eyelid spasms, mental changes
parcopa:
levodopa and carbidopa; dissolving tablet
stalevo
levodopa, carbidopa, and entacapone
pramipexole [Mirapex]
Non-Ergot alkaloids
DOPAMINE AGONIST
used alone early on and with l-dopa later on.
also used for restless leg syndrome
agonizes dopamine receptors at both presynaptic and postsynaptic sites
side effects:
Hallucinations, dizziness, drowsiness, nausea
Orthostatic hypotension (>50% in all patients)
Sleep attacks
Blood dyscrasias
apomorphine [Apokyn]
NON-ERGOT
subQ injection only used for “OFF” episodes this is not analgesic SIDE EFFECTS sleep attacks circulatory failure severe nausea and vomiting use TIGAN for 3 days prior to injection orthostatic hypotension anorexia agitation erections
ropinirol [Requip]
NON-ERGOT
also used for restless leg syndrome
side effects are syncope, drowsiness, fatigue
bromocriptine [Parlodel]
ERGOT DOPAMINE AGONIST
has many other uses too side effects are seizures shock mi PSYCH REACTIONS confusion, hallucinations, paranoia, nightmares
amantadine [Symmetrel]
ALSO AN ANTIVIRAL
amantadine [Symmetrel]
releases dopamine from neuronal storage sites.
blocks uptake of dopamine into presynaptic neurons
permitting peripheral and central accumulation of dopamine
