Shared Flashcard Set

Details

Neuro/Psych-Pharm
Anti-Parkinson's Meds
17
Pharmacology
Graduate
01/10/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
What dopamine receptors are located in the globus pallidus
Definition

Externa: D2

Interna: D1

 

Term
How does MPTP cause damage to the brain
Definition

Monoamine Oxidase degrades MPTP to MPP+

MPP+ blocks Complex I in Mitochondria Free radical formation that overwhelms glutathione reduction systems

The oxidative damage localizes in the dopanergic system bc MPTP is transported into cells by the dopamine transporter

Term
What are the clinical signs of Parkinson's
Definition

Tremor

Rigidity

Bradykinesia

Problems Intiating Walking

Absence of Facial Expression

Cognitive(Dementia)

Depression

Term
What are the side effects of Sinemet or Atamet? Which is very common?
Definition

Dykinesia(Most Common-80%): Grimacing, Restless feet<-> Chorea

Psychiatric: Hallucinations

Term
What are the contraindications to sinemet use?
Definition

Psychosis

Open Angle Glaucoma

Cardiac disease

Peptic Ulcer Disease

Melanoma

Nonspecific MAO-I's

Term
What is a treatment option for patients where sinemet wears off before the next dose
Definition
combine short and long acting preps
Term

What are the adverse effects of Bromocryptine?

What are the advantages?

Definition

Adverse

MI, Erythromelalgia, Digital vasospasm

Dyskinesia less than sinemet

Hallucinations more common than sinemet

Fibrosis of organ lining

Advantage

Less dyskinesia, less fluctuations

Term
What is the cause of the response fluctuations in long-term parkinson's
Definition
Higher dopamine release and shorter half life and therapeudic Window narrows as disease progresses
Term
What is the only MAO-I safely used with L-dopa
Definition
Selegiline bc it is MAO-B selective, however high doses can show MAO-A blockage
Term
Use of Selegiline is contraindicated with what other drugs?
Definition

Trycyclic Anti-depressants

SSRI's

Meperidine(Narcotic Analgesic)

Term

What is the mechanism of Amantadine use in parkinson's?

When is it used?

Adverse Effects?

What are the contraindications?

Definition

Dopamine release in striatum

Block Muscarinic and Glutamate Receptors

Use: Dopa dyskinesia

Adverse:

Livido reticularis

Peripheral edema

Hallucinations

Contraindications: CHF and Seizures

Term
Side effects of anticholinergics used in parkinson's
Definition

Anticholinergic effects

Dyskinesias

Hallucinations

Term
What are the COMT-I's used in parkinson's and when are they used in parkinson's
Definition

Tolcapone

Entacapone

Used in Wearing-off Phenomenon to allow doses of L-dopa to remain in the brain for longer duration

 

Term
What needs to be monitored with tolcapone use
Definition
Liver Function
Term
What are the first and last symptoms alleviated by parkinson's treatment
Definition

First: Mood and Vigor

Last: Tremor

Term
If administered together, how does Carbidopa affect the concentration of L-Dopa in the brain?
Definition
Peripheral inhibition increases L-dopa levels in the brain
Term
Concern with the use of Sinemet and MAO-I A inhibitors in combo?
Definition
Hypertensive crisis bc of increased norepinephrine production
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