T41d Antiparkinson Flashcards
Bromocriptine
Dopamine agonist. Ergot.
TX. hyperprolactinemoa, acromegaly (inhibitory to prolactin and GH), used to treat neuroleptic malignant hyperhtermia due to dopamine antagonists.
ADV. dyskinesias and psycosis
Apomorphine
anti-parkinson. dopamine receptor agonist.
Amantidine
Anti-viral as antiparkinsons. Anti-muscarinic and increases dopamine release and decrease DA reuptake.
DOA.
TX. parkinsons, livedo reticularis (skin palor and vessel dilate purple mesh under rash)
ADV. atropine-like (dry, mydriasis, lack cilliary accomodation, constipation, caution glaucoma)
Carbidopa
antiparkinson. peripheral aromatic amino acid decarboxylase (AAAD) irreversible non-competitive inhibition (decrease Vmax)
TX. does not cross BBB. given with Levodopa
Levodopa
Antiparkinson. increase Dopamine production thereby producing adaquate inhibitory stimulation at the GABAnergic inhibitory interneurons from the substatia nigra to the striatum. D2a-Gi coupled receptors.
DOA. crosses BBB. metabolised to Domapine by aromatic amino acid decarboxylase (AAAD) where dopamine cannot cross BBB.
TX. parkinsons
ADV: Peripheral dopamine stimulation - given with Carbidopa (peripheral AAAD inhibitor). On-Off effects of dyskinisea with dopamine metabolism. Mesolimbic/mesocortical dopamine stimulation causing psycosis. D1 periphral activation causing hypotension vasodilation and reflex arrythmias. Chemotrigger zone emesis. Prolactin inhibiton.
Pergolide
Dopamine agonist.
TX. hyperprolactinemoa, acromegaly (inhibitory to prolactin and GH), used to treat neuroleptic malignant hyperhtermia due to dopamine antagonists.
ADV. dyskinesias and psycosis
Entacapone
antiparkinson. inhibit COMT to enhance levodopa uptake and prevent partial agonist (duality antagonist) 3-0-methyldopa.mine formation.
Pramipexole
Dopamine agonist and anti-oxidants
TX. antiparkinsons (supportive and decrease progression) . hyperprolactinemoa, acromegaly (inhibitory to prolactin and GH)
ADV. dyskinesias and psycosis
Rasagiline
antiparkinson. MAOb selective inhibitor (no tyramine/NE interactions - no hypertensive effect)
DOA. 5x more potent than selegiline. crosses BBB.
TX. intial treatment and adjunct in levodopa
ADV. dyskinesias, psychosis, no insomnia/anxiety.
Ropinirole
Dopamine agonist and anti-oxidants
TX. antiparkinsons (supportive and decrease progression) . hyperprolactinemoa, acromegaly (inhibitory to prolactin and GH)
ADV. dyskinesias and psycosis
Selegiline
antiparkinson. MAOb selective inhibitor (no tyramine/NE interactions - no hypertensive effect)
DOA. crosses BBB. metabolized to amphetamine
TX. intial treatment and adjunct in levodopa
ADV. dyskinesias, psychosis, insomnia/anxiety (amphetamine, drug test posititve)
Rotigotine
antiparkinson. Dopamine receptor agonist.
Tolcapone
antiparkinson. inhibit COMT to enhance levodopa uptake and prevent partial agonist (duality antagonist) 3-0-methyldopa.mine formation.
TX.
ADV. hepatotoxic
