Term
| What medications are first-line tx for essential tremors? |
|
Definition
| Propranolol and primidone |
|
|
Term
|
Definition
| Neuroleptics, botulinum toxin for motor tics |
|
|
Term
| Concomitant use of what two drug classes can induce tardive dyskinesias? |
|
Definition
| Neuroleptics & antimuscarinics |
|
|
Term
| What is the function of carbidopa? |
|
Definition
Peripheral dopa decarboxylase inhibitor
• Always co-administered with levodopa
• Reduces peripheral metabolism of levodopa so that
lower levodopa doses can be administered with equal
effect |
|
|
Term
| Function of COMT inhibitors? |
|
Definition
| Mechanism: reduces peripheral metabolism of levodopa and decrease concentration of 3-O-methyldopa which may compete with levodopa for transport across BBB |
|
|
Term
| Examples of COMT inhibitors? |
|
Definition
|
|
Term
| Which is associated w/ hepatotoxicity yet more readily crosses the BBB: etacapone or tolcapone? |
|
Definition
|
|
Term
| Effect of COMT inhibitors on urine? |
|
Definition
|
|
Term
|
Definition
• Adenosine antagonist --> may decrease
D2 receptor inhibition
• Most effective agent to reduce levodopa-induced dyskinesias |
|
|
Term
| Which dopamine agonist is only available through special pharmacy and has profound emetic effects? |
|
Definition
|
|
Term
| What antiemetic agent must be prescribed 3 days before starting apomorphine therapy? |
|
Definition
|
|
Term
| Adverse FX of deep brain stimulation? |
|
Definition
• Paresthesia
• Dysarthria
• Dizziness
• Dyskinesia
• Facial contractions
• Rare: surgical complications |
|
|
Term
|
Definition
Viral vector injected into putamen of Parkinson's patients
Still being studied |
|
|
Term
| Options to deal with on-off phenomenon associated w/ levodopa therapy? |
|
Definition
| you can change to a controlled-release formulation; switch to a combination product such as Stalevo, which includes a COMT inhibitor; or add a MAO-B inhibitor or dopamine agonis |
|
|
Term
| Antipsychotics used to tx non-motor symptoms of Parkinson's? |
|
Definition
Clozapine (may cause agranulocytosis) or quietiapine
Avoid olanzapine |
|
|
Term
| Antidepressants used in Parkinson's pts? |
|
Definition
| Amitriptyline or SSRIs (better tolerated) |
|
|
Term
| Tx for cognitive decline in Parkinson's pts? |
|
Definition
Rivastigmine (may worsen tremor)
Also donezepil, memantine, or galantine may have benefit |
|
|
Term
|
Definition
| Acetylcholinesterase inhibitor |
|
|
Term
| Pain mgmt in Parkinson's? |
|
Definition
| Gabapentin or pregabalin, duloxetine |
|
|
Term
| Fatigue mgmt in Parkinson's pts? |
|
Definition
| Methylphenidate, modafinil |
|
|
