Term
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Definition
Class: movement disorder, DA/DA agonist
Mechanism: converted to DA via dopa decarboxylase (AADC) within brain
Indication: symptoms of PD, particularly bradykinesia; admin w/ carbidopa
Adverse effects: ON-OFF PHENOMENON (minutes to hours of hypokinesia due to short half-life of drug); N, postural hypotension, agitation, confusion, hallucinations, depression, dyskinsesias (face and distal extremeties, w/in 2yrs, at peak of therapeutic effect) |
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Term
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Definition
| Class: movement disorder, DA/DA agonist |
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Term
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Definition
Class: movement disorder, DA/DA agonist
Mechanism: ergot derivative, agonist at D2 receptor, partial agonist at D1
Indication: PD, acromegaly, hyperprolactinemia
Advantage: less assoc. w/ on-off phenomenon than l-dopa
Adverse effects: less used, N, postural hypotension, agitation, hallucination (> w/ l-dopa, don't use in elderly) |
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Term
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Definition
Class: movement disorder, DA/DA agonist
Mechanism: non-ergot derivative, agonist at D2 and D3 receptors
Indication: PD, restless leg syndrome
Advantages: less assoc. w/ on-off phenomenon, favored over ergot derivatives
Adverse effects: N, postural hypotension, agitation, hallucinations; SUDDEN SLEEP ONSET
TRANSDERMAL PATCH w/ rotigotine |
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Term
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Definition
Class: movement disorder, DA/DA agonist
Mechanism: non-ergot derivative, agonist at D2 receptor
Indication: PD, restlest leg syndrome
Advantages: less assoc. w/ on-off phenomenon, favored over ergot derivatives
Adverse effects: N, postural hypotension, agitation, hallucinations; SUDDEN SLEEP ONSET
TRANSDERMAL PATCH w/ rotigotine |
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Term
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Definition
Class: movement disorder, DA/DA agonist
Mechanism: dopamine receptor agonist
Indication: PD rescue therapy
Advantages: subq injection --> rapid relief of off periods of akinesia w/ l-dopa therapy
Adverse effects: only temporary relief (1-2hr), severe N, postural hypotension, DROWSINESS, hallucinations, dyskinesias |
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Term
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Definition
Class: movement disorder, enzyme inhibitor
Mechanism: peripheral inhibitor of AADC, does not cross BBB
Indication: symptoms of PD, esp. bradykinesia; coadmin with l-dopa
Adverse effects: N, postural hypotension, agitation, confusion, hallucinations, depression, dyskinesias |
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Term
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Definition
Class: movement disorder, enzyme inhibitor
Mechanism: selective inhibition of MAO-B, decrease degradation of DA/levodopa; 2nd gen formulation
Indication: PD
Advantages: good adjunct w/ levodopa, SS and HT crisis are less likely than with MAO-A inhibitors
Adverse effects: minimal use as monotherapy, N, postural hypotension, dykinesias |
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Term
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Definition
Class: movement disorder, enzyme inhibitor
Mechanism: inhibit COMT, decrease degradation of DA/levodopa; periphery only action
Indication: PD
Contraindication: coadmin with nonselective MAOs
Advantage: increases on-time of levodopa
Adverse effects: minimal use as monotherapy, N, postural hypotension, agitation, hallucinations, dyskinesias; DISCOLORED URINE (dark yeallow, reddish brown, alkaline) |
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Term
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Definition
Class: movement disorder, other PD
Mechanism: antiviral, enhanced DA neurotransmission via altering DA release?, anticholinergic effects?
Indication: Influenza A tx and prophylaxis, PD
Adverse effects: only temporary relief (few weeks), otherwise tolderated well |
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Term
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Definition
Class: movement disorder, other PD
Mechanism: antimuscarinic, targets the unopposed ACh action in basal ganglia to restore DA-ACH balance
Indication: PD esp. tremor and rigidity
Advantages: generally used early in therapy for mild symptoms
Adverse effects: confusion (esp. elderly), blurred vision, urinary retention, other antimuscarinic effect |
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Term
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Definition
Class: movement disorder, toxin
Mechanism: toxic byproduct of too long or too hot rxn to make MPPP (china white, a street drug); converted to toxic metabolite by MAO-B, taken up by dopa neurons --> oxidative stress --> destruction of neurons --> Parkinson's (frozen addict syndrome)
Prevention: selegiline, rasgilene |
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Term
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Definition
Class: movement disorder, Huntington's
Mechanism: reversible inhibitor of VMAT2 (>in brain), decrease vesicular storage of DA
Indication: chorea assoc. w/ Huntinton's, Tourette's syndrome
Adverse effects: RISK OF DEPRESSION/SUICIDAL IDEATION, extrapyramidal symptoms, sedation, CYP2D6 metabolism, expensive |
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Term
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Definition
Class: movement disorder, Huntington's
Mechanism: DA receptor antagonist
Indication: antipsychotic, chorea assoc. w/ Huntington's, Tourette's syndrome
Adverse effects: decrease fine motor coordination, increase rigidity, extrapyramidal symptoms, QT prolong, potential life-threat arrhythmias |
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Term
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Definition
Class: movement disorder, Wilson's
Mechanism: coppor chelation
Indication: Wilson's disease
Adverse effects: early sensitivity rxn (fever, thrombocytopenia, cutaneous eruptions), nephrotic syndrome, worsening of neurologic symptoms |
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Term
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Definition
Class: movement disorder, spasticity
Mechanism: agonist at GABA(B) receptors, reduce Ca influx, less NT release, opening of K channels --> hyperpolarize
Indication: spasiticity
Advantages: less sedation than benzo, less reduction in muscle strength than dantrolene
Adverse effects: tolerance and WITHDRAWAL, some sedation, some muscle weakness |
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Term
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Definition
Class: movement disorder, spasticity
Mechanism: long-acting benzodiazepine, potentiates effects of GABA at GABA(A) receptors; allosteric modulator, decrease likelihood of muscle AP
Indication: spasticity, anxiety, epilepsy, (to sedate)
Adverse effects: sedation, cognitive impairment, abuse potential |
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Term
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Definition
Class: movement disorder, spasticity
Mechanism: alpha2 agonist (cogener of clonidine), linked to Gi protein
Indication: spasticity, certain headaches
Advantages: fewer CV effect than clonidine, less muscle weakness than diazepam, baclofen, dantrolene
Adverse effects: drowsiness, hypotension, dry mouth, hepatotoxicity |
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Term
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Definition
Class: movement disorder, spasticity
Mechanism: NOT CENTRAL ACTING, bind ryanodine receptor, blocks opening, decreases release of Ca from SR in muscle fiber
Indication: spasticity, malignant hyperthermia
Advantages: less sedation than diazepam or baclofen
Adverse effects: generalized muscle weakness, sedation, POTENTIAL SERIOUS HEPATOTOXICITY |
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Term
| common side effects of PD drugs |
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Definition
GI - nause
postural hypotension
behavior - agitation, confusion, hallucinations, depression
dyskinesias - usually face and distal extremeties |
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