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27 Cards in this Set
- Front
- Back
What drugs may cause Parksonian symptoms?
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Drugs which deplete dopamine (Reserpine) or block receptors (antipsychotics: chlorpromaine, haloperidol)
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What type of drug is Pramipexole?
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D2 agonist
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What type of drug is Ropinirole?
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D2 agonist
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What type of drug is Bromocriptine?
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D2 agonist
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What type of drug would you use for drug-induced extrapyramidal effects?
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Anticholinergic agents
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What is the rate limiting step in dopamine synthesis?
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Tyrosine Hydroxylase (Tyrosine-->DOPA) That is why we give DOPA (to skip the bottleneck)`
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Why don't we give Dopamine?
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Cannot cross the BBB
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What is a GI side effect of Levodopa?
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GI (Nausea and vomiting) due to stimluation of chemoreceptor Trigger zone
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Patients with what may be a contraindication to Levodopa?
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Heart problems (NE and Epi synthesized from dopamine in some neurons)
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wWhat side effect of Levodopa occurs in about 15% of patients?
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Psychiatric/behavioral problems
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What is the point of administering Carbidopa with Levodopa?
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It prevents periphera conversion of l-dopa to dopamine and allows for lower doses of Levodopa
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What are some advantages to using Carbidopa?
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Can reduce the effective dose of Levodopa, reduced GI symptoms, more control
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What are some disadvantages to using Carbidopa?
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Orthostatic Hyoptension not helped, involuntary movements may occur earlier, be more severe, and last longer
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What precautions do you need to use when using Carbidopa and Levodopa?
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Psychiatric patients, pts with asthma or emphsyma using other adrenergic agents, and pts on MAO-A inhibitors
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a useful adjunct especially in patients with an "end of dose" fluctuating response to treatment
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Entacapone
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What type of drug is Entacapone?
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COMT inhibitor
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What enzyme does Carbidopa inhibit?
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DOPA decarboxylase (L-DOPA to Dopamine)
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What drugs have also been proven to treat restless leg syndrome?
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Pramipexole and Ropinirole
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What are some advantages to using Pramipexole and Ropinirole?
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Less likely to induce dyskinesias and longer duration of action
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What type of drug is Amatidine?
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Antiviral agent (NMDA antagonist)
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What type of drug is Selegiline?
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MAO-B inhibitor (preserves dopamine in the basal ganglia)
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What is a side effect of Selegiline?
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Insomnia probably due to an amphetamine like metabolite
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What is Selegiline metabolized to?
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Amphetamine derivative that may be neurotoxic
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What type of drug is Trihexyphenidyl?
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Anticholinergic agent
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What type of drug is Benztropine?
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Anticholinergic agent
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What two drugs are the only approach to drug-induced Parkinson effects?
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Trihexyphenidyl and Benztropine (can't work on the dopamine side, thus work on the cholinergic side)
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What are some side effects of anticholinergic agents (Trihexyphenidyl and Benztropine)?
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Heat stroke (no sweating), urinary retention, failure to accommodate
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