Parkinson's Disease Flashcards

1
Q

This is the immediate precursor to dopamine. It is the gold standard for treatment of Parkinson’s. Crosses the BBB

A

Levodopa

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2
Q

This drug inhibits aromatic L-amino acid decarboxylase in the periphery

A

Carbidopa

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3
Q

What are 3 strategies to address wearing off of Levodopa/Carbidopa

A
  • increase dose or dose number
  • add a dopamine agonist
  • use a COMT inhibitor
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4
Q

ADRS are N/V/anorexia, tachycardia, arrhythmias, visual and auditory hallucinations, depression, mania, anxiety, dyskinesia

A

Levodopa/Carbidopa

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5
Q

Drug interactions with vitamin B6 (pyridoxine), MAO inhibitors, antipsychotics

A

Levodopa/Carbidopa

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6
Q

This class of drugs have reduced risks of motor complications and dyskinesias compared to Levodopa/Carbidopa

A

Dopamine agonists

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7
Q

These two dopamine agonists are FDA indicated as monotherapy

A

Pramipexole

Ropinirol

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8
Q

This class of drugs can be neuroprotective. It decreases autooxidation and free radical formation in the brain. Reduces levodopa requirements

A

Dopamine agonists

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9
Q

ADRs include N/V, orthostasis, psychosis, narcolepsy

A

Dopamine agonist

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10
Q

Can cause increased risk of compulsive gambling due to stimulation of dopamine release in the mesolimbic pathway

A

Dopamine agonists

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11
Q

This dopamine agonist has a 3 hour half life, high first pass metabolism and is highly protein bound

A

Bromocriptine

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12
Q

This dopamine agonist has an 8-12 hour half life and is renally excreted

A

Pramipexole

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13
Q

Adverse effects include sedation, hypotension, delusions or psychosis, dyskinesias, N/V, and leg edema

A

Dopamine agonists

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14
Q

This dopamine agonist is transdermal, has a high affinity for DA receptor subtypes, and can be used as monotherapy or adjunct therapy

A

Rotigotine

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15
Q

AEs of this dopamine agonist include application site rxns, nausea, somnolence, sudden onset of sleep, and brief LOC while driving

A

Rotigotine

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16
Q

This MAOB inhibitor can extend the time before l-dopa is needed by 9 months and can extend its action for up to an hour

A

Selegiline

17
Q

ADRs include insomnia, jitteriness, HTN, worsen preexisting hallucinations and delusions. Can cause a rare serotonin syndrome with concomitant SSRI treatment

A

Selegiline

18
Q

This is transdermal Selegiline

A

Emsam

19
Q

This is a selective, irreversible MAO-B inhibitor that is 5x more potent than Selegiline

A

Rasagiline

20
Q

2 Parkinsons drugs metabolized by CYP 1A2

A

Ropinirole, Rasagiline

21
Q

This drug is used as an adjunct to L-dopa, is more efficacious than anticholinergic agents, and relieves symptoms of bradykinesia, rigidity, and tremor

A

Amantidine

22
Q

This drug has fewer side effects than L dopa or anticholinergic agents. Can cause hallucinations. confusion, and nightmares when administered with an anticholinergic

A

Amantidine

23
Q

ADRs include insomnia, dizziness, and slurred speech. CAUTION in patients with renal disease

A

Amantidine

24
Q

Indicated for tx in pts with PD experiencing end of dose wearing off with l-dopa

A

COMT inhibitors

25
Q

These agents have NO ROLE AS MONOTHERAPY

A

COMT inhibitors

26
Q

This COMT I is highly protein bound and readily absorbed. You need to do strict LFT monitoring, DC if signs of liver failure (there is even an informed consent on package insert)

A

Tolcapone

27
Q

Can cause delayed onset diarrhea and brownish orange fluid discoloration, and orthostasis

A

Tolcapone

28
Q

This COMT I causes diarrhea and orthostasis, brownish-orange urine discoloration, but NO evidence of hepatotoxicity

A

Entacapone

29
Q

This drug is a combo of carbidopa, levodopa, and entacapone

A

Stalevo

30
Q

These 2 anticholinergic drugs arent as effective as l-dopa but CAN be effective against tremor and dystonic features. Ineffective against bradykinesia

A

Trihexphenidyl

Benzotropine

31
Q

ADRS: dry mouth, blurred vision, constipation, urinary retention, sedation memory impairment, confusion, dysphoria, hallucinations

A

Anticholinergics