Pharm 2: Neurodegeneration

Parkinson's-DP enhancer
DP intermediate, "precursor loading"
initially relieves all Sx except dementia, 3-4 years
SE: N/V, ortho hypotension, arrhythmia, diskinesias
Contra: schizophrenia, dysrhythmia and CAD

Parkinson's-DP enhancer
MOA: inhibits peripheral decarboxylation of levodopa, increasing amount in brain
decreases effective dose, diminishes N/V, CV side effects

Parkinson's-DP enhancer
MOA: dopamine agonist acting at dopamine2 (D2) receptors but antagonist at D1 receptors
not first line, used refractory to levodopa
SE: like L-dopa, 1st dose effect-hypotension, hallucinations, vasospasm

Parkinson's-DP agonist
can be used w/ or w/o L-dopa
Pramipexole anti-depressant

Parkinson's-DP agonist
brand new transdermal patch formulationa non-ergot dopamine agonist

Parkinson's-DP agonist
used to treat freezing episodes

Parkinson's-DP agonist
MOA: inc. release of DP
less effective than L-dopa
SE: depression, insomnia, agitation, spider veins
CI: seizures or CHF

Parkinson's: DP breakdown inhibitor
MAO: selective MAO-B inhibitor
inc. efficacy of L-dopa use
prevents rigid addict from happening

Parkinson's: DP breakdown inhibitor
MOA: newer MAO-B selective inhibitor

Parkinson's: DP breakdown inhibitor
MOA: reversible inhibitor of catechol-O-methyl-transferase (COMT)
adjunct for L-dopa at end of treatment
SE: have to monitor liver, cant have movement abnormalities

Parkinson's: DP breakdown inhibitor
MOA: reversible inhibitor of catechol-O-methyl-transferase (COMT)
adjunct L-dopa
longer, better than Tolcapone

Parkinson's: anticholinergic agents
MOA: antimuscarinic
can be used w/ or w/o L-dopa
SE: confusion, mood changes, blurred vision, tachy, mydriases, constipation

Parkinson's: anticholinergic agents
MOA: antimuscarinic
can be used w/ or w/o L-dopa
SE: confusion, mood changes, blurred vision, tachy, mydriases, constipation

Parkinson's: neuroprotective agent
MOA: inhibits monamine oxidase type B (MAO-B)
treatment early in the course of PD delays the onset of more severe symptoms

Fluoxetine (Prozac)-treat depression and irritability
Clozapine (Clozaril)-Rx of psychosis, paranoia & other delusional states
Reserpine-Used for large amplitude chorea

Huntingtons
mech of ax: reversible depletor of monoamines (dopamine, 5-HT, norepineprhine) in the brain

Alzheimers: Acetylcholinesterase Inh.
MOA: Centrally-acting AChE inhibitor
absorbed rapidly, peak 1-2
SE: Hepatotoxicity Cholinomimetic effects

Alzheimers: Acetylcholinesterase Inh.
MOA: Centrally acting AChE inhibitor
100% bioavail., peak 3-4 hours
SE: Cholinomimetic effects-
nausea, vomiting, diarrhea, muscle cramps and fatigue

Alzheimers: Acetylcholinesterase Inh.
MOA: 2X daily central AChE inhibitor which is devoid of liver metabolism
Cognitive improvement

Alzheimers: Acetylcholinesterase Inh.
MOA: Central AChE inhibitor AND nicotinic agonist

Alzheimers: Acetylcholinesterase Inh.
MOA: NMDA (glutamate) antagonist
Prevents excitotoxicity due to excess glutamate

MS
halt and even reverse the progression of MS
MOA: increasing the cytotoxicity of NK cells; increasing phagocytic activity of macrophages
reduces interferon-gamma secreted by lymphocytes

MS
same as interferon beta 1b

MS
MOA: blocks cell adhesion pathway and inhibits lymphocytes entry into the CNS (can cause pathology of MS)

MS
MOA: mimics myelin basic protein, a component of the myelin covering nerve fibers
acts as a decoy to T cells that damage myelin

MS
MOA: suppresses activity of T cells, B cells, and macrophages that attack the myelin sheath

MS
MOA: anti-inflammatory activity; corticosteroids shorten the duration of relapse and lessen symptoms

MS
MOA: inhibit spinal reflexes

ALS
MOA: Inhibits glutamate release
Blocks glutamate receptors
Inhibits Na+ channels
and undefined GPCR interaction
SE: elevation of Hep. enzymes, N/V MINOR

ALS
MOA: GABA-B agonist
Increases the extensor tone and clonus
used to treat spasticity of the muscles