Term
|
Definition
| transported into CNS, converted to dopamine |
|
|
Term
| What are the peripheral dopaminergic effects of levodopa? |
|
Definition
| anorexia, nausea, vomiting, cardiac arrhythmias, postural hypotension, hypertension, dyskinesias, changes in mood or personality, mydriasis, etc |
|
|
Term
| why isn't levodopa always used as first drug in Parkinson's disease? |
|
Definition
| development of disabling response fluctuations over time |
|
|
Term
| Name the drug: 6-8 effect, tox: GI upset, arrhythmias, dyskinesias, on-off, behavioral disturbances |
|
Definition
|
|
Term
| What drug diminishes the dosage of levodopa required? Which drugs prolong the duration of effect? |
|
Definition
| carbidopa, COMT or MAO-B inhibs |
|
|
Term
| Does carbidopa enter the CNS? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| levodopa, carbidopa and entacapone |
|
|
Term
| Which drug is a direct agonist at D3 receptors? Is it an ergot? |
|
Definition
|
|
Term
|
Definition
| reduces symptoms of park's, smooths out fluctuations in levodopa response |
|
|
Term
| pramipexole: clinical applications? |
|
Definition
| park's, initial therapy or for on-off phenomenon |
|
|
Term
| How is pramipexole taken? What is the DOA? Tox? |
|
Definition
| orally, 8 hrs, nausea, vomiting, postural hypotension, dyskinesias |
|
|
Term
| Ropinirole is similar to which other drug? What is the MOA? Is it an ergot? |
|
Definition
| pramipexole, relatively pure D2 agonist, nonergot |
|
|
Term
| Bromocriptine is a potent agonist at ___ receptors |
|
Definition
|
|
Term
| Name an ergot derivative that is an agonist at D2 |
|
Definition
|
|
Term
| How does the toxicity of bromocriptine compare to pramipexole or ropinirole? |
|
Definition
|
|
Term
| Is apomorphine an ergot derivative? What is it used for? There is a high incidence of which side effects? what is the MOA? |
|
Definition
| no, subcutaneous route useful for rescue treatment in levodopa-induced dyskinesia, nausea and vomiting, it is a potent dopamine agonist |
|
|
Term
| What are pramipexole, ropinirole, bromocriptine and apomorphine? |
|
Definition
|
|
Term
| Name the dopamine agonists |
|
Definition
| pramipexole, ropinirole, bromocriptine, apomorphine |
|
|
Term
| What are rasagiline and selegiline? |
|
Definition
|
|
Term
| name 2 MAOIs used in movement disorders |
|
Definition
| rasagiline and selegiline |
|
|
Term
| What is the MOA of rasagiline? |
|
Definition
| inhibits MAO-B selectively, higher doses also inhibit MAO-A |
|
|
Term
| Which drug inhibits MAO-B, and at higher doses also inhibits MAO-A? |
|
Definition
|
|
Term
| What are the effects of rasagiline? |
|
Definition
| increases dopamine stores in neurons, may have neuroprotective effects |
|
|
Term
| Clinical applications for rasagiline? |
|
Definition
| park's, adjunctive to levodopa, smooths levodopa response |
|
|
Term
| How is rasagiline taken? Toxicity and interactions? |
|
Definition
| orally, may cause serotonin syndrome with meperidine, theoretically also with SSRIs and TCAs |
|
|
Term
| Selegiline is like which other drug? May be less potent in what situation? |
|
Definition
| rasagiline, MPTP-induced park's |
|
|
Term
| Which drugs used for movement disorders could cause serotonin syndrome with SSRIs, meperidine, or TCAs? |
|
Definition
|
|
Term
| Name 2 COMT inhibitors used in movement disorders |
|
Definition
|
|
Term
| what are entacapone and tolcapone? |
|
Definition
|
|
Term
| What is the MOA of entacapone? |
|
Definition
| inhibits COMT in periphery, does not enter CNS |
|
|
Term
| which drug inhibits COMT in the periphery? |
|
Definition
|
|
Term
| What are the effects of entacapone? |
|
Definition
| reduces metabolism of levodopa and prolongs action |
|
|
Term
| Which drug reduces the metabolism of levodopa and and prolongs its action? |
|
Definition
|
|
Term
| clinical applications for entacapone? |
|
Definition
|
|
Term
| How is entacapone taken? Toxicity? |
|
Definition
| orally, increased levodopa toxicity, nausea, dyskinesia, confusion |
|
|
Term
| Tolcapone is like which other drug? Does it enter the CNS? Tox? |
|
Definition
| entacapone, YES it enters the CNS, some evidence of hepatotoxicity and elevation of liver enzymes |
|
|
Term
| Which drug enters the CNS to inhibit the metabolism of levodopa? |
|
Definition
|
|
Term
| Name some antimuscarinic agents used in movement disorders |
|
Definition
| benztopine, biperiden, orphenadrine, procyclidine, trihexyphenidyl |
|
|
Term
| What kind of drugs are these: benztopine, biperiden, orphenadrine, procyclidine, trihexyphenidyl |
|
Definition
|
|
Term
|
Definition
| antagonist at M receptors in basal ganglia |
|
|
Term
| Which drug is an antagonist at M receptors in basal ganglia? |
|
Definition
|
|
Term
| what are the effects of benztropine? |
|
Definition
| reduces tremor and rigidity, little effect on bradykinesia |
|
|
Term
| Which drug reduces tremor and rigidity but has little effect on bradykinesia? |
|
Definition
|
|
Term
| clinical application for benztropine? |
|
Definition
|
|
Term
| how is benztropine taken? Toxicity? |
|
Definition
| orally, antimuscarinic effects: sedation, mydriasis, urinary retention, dry mouth |
|
|
Term
| Name some drugs used in Huntington's disease |
|
Definition
| tetrabenazine, reserpine, haloperidol |
|
|
Term
| tetrabenazine, reserpine and haloperidol are used in which situation? |
|
Definition
|
|
Term
| What is the MOA of tetrabenazine and reserpine? |
|
Definition
| depletes amine transmitters, especially dopamine, from nerve endings |
|
|
Term
| which drugs deplete amine transmitters, especially dopamine, from nerve endings |
|
Definition
| tetrabenazine and reserpine |
|
|
Term
| what are the effects of tetrabenazine and reserpine? |
|
Definition
|
|
Term
| How are tetrabenazine and reserpine taken? Toxicity? Which is somewhat less toxic? |
|
Definition
| orally, hypotension, sedation, depression, diarrhea, tetrabenazine is somewhat less toxic |
|
|
Term
| which drugs can cause hypotension, sedation, depression and diarrhea? |
|
Definition
| reserpine and tetrabenazine |
|
|
Term
| Which drugs are used in Tourette's? |
|
Definition
| haloperidol, clonidine, phenothiazines, benzodiazepines, carbamazepine |
|
|
Term
| haloperidol, clonidine, phenothiazines, benzodiazepines and carbamazepine are sometimes used for... |
|
Definition
|
|
Term
| What is the MOA of haloperidol? |
|
Definition
| blocks central D2 recepts |
|
|
Term
| which drug blocks central D2 recepts? |
|
Definition
|
|
Term
| What are the effects of haloperidol in Tourettes? |
|
Definition
| reduces vocal and motor tic frequency and severity |
|
|
Term
| How is haloperidol taken? Toxicity? |
|
Definition
| orally, parkinsonism, other dyskinesias, sedation |
|
|
Term
| Clonidine is effective in about __% of Tourette's pts |
|
Definition
|
|
Term
| Which drugs are "sometimes of value" in Tourettes? |
|
Definition
| phenothiazines, benzos, carbamazepine |
|
|
Term
| What is the preferred tx for RLS? |
|
Definition
| dopaminergic therapy - pramiprexole or ropinirole |
|
|
Term
| adverse effect of antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible |
|
Definition
| Drug induced Parkinsonism |
|
|
Term
| Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma |
|
Definition
|
|
Term
| Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia |
|
Definition
|
|
Term
| What is the weird toxic effect of bromocriptine? |
|
Definition
|
|
Term
| Enhances dopaminergic neurotransmission, SE's include CNS excitation, acute toxic psychosis and livedo reticularis |
|
Definition
|
|
Term
| What does amatadine do? side effects? |
|
Definition
| Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis |
|
|
Term
| Agent effective in physiologic and essential tremor |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Chelating agent used in Wilson's disease |
|
Definition
|
|
