Week 12: Dopaminergics & Dopamine Agonist

Question 1

parkinson’s disease affects what neurotransmitters

Answer 1

Dopamine & Ach helps with balance and muscle coordination. Less dopamine = muscle rigidity, tremors, psychomotor retardation

Question 2

carbidopa-levodopa (Sinemet) indication & MOA

Answer 2

parkinsons

levodopa in plasma crosses BBB into dopamine

carbidopa stops levodopa breakdown in plasma so there’s more at the BBB

Question 3

how to take carbidopa-levodopa (Sinemet)?

Answer 3

EMPTY STOMACH
take when want to be functional (like eating, presenting)

good for motor impairment

Question 4

carbidopa-levodopa (Sinemet) c/c

Answer 4

NO narrow angle glaucoma, psych disorders, melanoma

caution CVD, elderly

stop abruptly = neuroleptic malignant syndrome

Question 5

carbidopa-levodopa (Sinemet) ADE

Answer 5

Orthostatic hypotension, somnolence, dizziness, headache, depression, nausea, constipation, dyskinesia, hypertension, insomnia, abnormal dreams, neuroleptic malignant syndrome (rare), peripheral neuropathy (rare)

Question 6

Baclofen MOA & indc

Answer 6

muscle relaxant

Inhibits monosynaptic and polysynaptic reflexes transmission at the spinal cord level
hyperpolarization of primary afferent fiber terminals = relief of muscle spasticity

ind: muscle spasms

Question 7

muscle relaxant:

baclofen c/c

Answer 7

NO preg

caution in renal, elderly (beers), seizure, lactation

Question 8

baclofen ADE

Answer 8

Drowsiness, confusion, headache, nausea, vomiting, hypotension, seizures

Question 9

cyclobenzaprine (Flexeril) MOA & ind

Answer 9

muscle relaxant

Act on the monosynaptic and polysynaptic spinal reflexes; inhibiting the synaptic reflex arcs affects the messages that are producing and maintaining the skeletal muscle spasm

indc: muscle spasms

Question 10

cyclobenzaprine (Flexeril) c/c

Answer 10

NO hyperthyroidism, HF, arrhythmias, heart block, MI recovery

caution urinary retention, glaucoma, ocular pressure

do not use longer than 3 weeks bc don’t know efficacy

Question 11

Tizanidine MOA & Ind

Answer 11

muscle relaxant

Centrally acting alpha-2 adrenergic agonist that reduces muscle spasticity by presynaptic inhibition of motor neurons

Question 12

Tizanidine ADE

Answer 12

NOT sedating

Dry mouth, weakness, fatigue, constipation, hypotension, bradycardia, hepatotoxicity (rare), anaphylaxis and angioedema (rare)

Question 13

cyclobenzaprine (Flexeril) ADE

Answer 13

Dry mouth, drowsiness, fatigue, nausea, vomiting, constipation, hallucinations, blurred vision

Risk for serotonin syndrome

Question 14

Tizanidine c/c

Answer 14

NO hepatic impairment, alcohol use, preg/lac

do not stop abruptly