Week 4 Flashcards
Damage to the ________ causes Parkinson Disease
Substantia nigra
When substantia nigra neurons die ________ decrease and ________ increase
- dopamine
- acetylcholine
Sign and Symptoms of Parkinson’s disease
(TRAP)
Tremors (resting)
Rigidity (cogwheel)
Akanesia (slow movement
Postural instability
Meds for parkinson’s disease increase ________ and decrease _______
- dopamine
- acetycholine
Dopamine Agonists
- levodopa/carbidopa
- Pramipexole
- Ropinirole
(Prescribed for Parkinson’s disease and RLS)
Levodopa is converted to __________
dopamine (once it has crossed the BBB)
Carbidopa help keep __________ low
levodopa
Pramipexole and Ropinirole are ___________ agonists
dopamine (stimulate dopamine receptors)
Carbidopa prevents the conversion of
levodopa to dopamine before it crosses the BBB
Protein, vitamin B6, and iron prevent the absorption of _________
levodopa/carbidopa
Orthostatic hypotension is caused by ______
dopamine alteration
Dopaminergic medications can cause paranoia and _____________
hallucination
Pramipexole and ropinirole can cause __________
impulse control issues (gambling, shopping, binge eating)
Selegiline oral form is for
Parkinson’s disease
Selegiline transdermal version is for ___________
Depression
Selegiline MOA (mechanism of action)
- MOA-B inhibitor (prevents breakdown of dopamine)
- Avoid tyramine rich food (cheese, smoke meat, fig, beer, soy sauce)
- Avoid other drugs that increase monoamines
Anticholinergics meds
- Benztropine
- Trihexyphenidyl
Anticholinergic uses and MOA
- treat parkinson’s disease and extrapyramidal effects
- Block acetylcholine receptors
- Cause drowiness
Monoamine Oxidase Inhibitors (MAOIs) meds
- Isocaboxazid
- Phenelzine
- Selegiline transdermal
- Tranylcypromine
Monoamines Oxidase Inhibitors (MAOIs) use and MOA
- treats major depression
- Blocks monoamine oxidase ( oxidase break down dopamine, serotonin, norepinephrine)
- Increase serotonin, norepinephrine and dopamine levels
- Avoid food containing tyramine (i.e., old and stinky)
- Avoid drugs that increase same neurotransmitters ( antidepressants, cold meds, meperidine, triptan)
___________ process produces high levels of tyramine
fermenting
Tyramine and _____________ cause a patients blood pressure to become too high
norepinephrine
(hypertension can manifest as a headache)
Serotonin syndrome is characterized by an altered _______ status
mental
(also high fever, sweating and clonus)
2. Clonus is involuntary rhythmic muscle contraction
Many patients that take MAOI experience __________
orthostatic hypotension
Tricyclic Antidepressants (TCAs) meds
- Amitriptyline
- Nortriptyline
TCAs uses and MOAs
- help treat depression, neuropathic pain, and anxiety disorders
- Block serotonin and norepinephrine reuptake pump cause them to increase
- TCA are not selective and causes anticholinergic affects
- Orthostatic hypotension is common
- TCAs can cause heart dysrhythmias when overdosed
Selective Serotonin Reuptake Inhibitors (SSRIs) meds
- escitalopram
- Fluoxetine
- Paroxetine
- Sertraline
SSRI use and MOA
- used for depression
- Block serotonin reuptake pumps
SSRI side affects
stomach troubles
slowed metabolism
sexual dysfunction
suicidal ideation
sodium levels decreased
SSRIs are sedating but Fluoxetine is activating (take fluoxetine in the morning)
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) meds
- desvenlafaxine
- duloxetine
- Venlafaxine
SNRIs uses, MOA, HYC
- used for major depression, neuropathic pain and anxiety
- MOA: Venlafaxine and duloxetine block the reuptake of serotonin and norepinephrine
- Same as TCAs but cleaner
- cause hypertension, stomach trouble, slowed metabolism, sexual dysfunction, suicidal ideation, decreased sodium