-imbalance of dopamine & acetylcholine

-no facial expression, pacing, fidgety, bradykinesia

-Tremors Rigidity Akinesia Postural changes

Artane

Cogentin

Norflex

SE: orthostatic hypotension

-reduce symptoms & increase mobility

-combined L-dopa with carbidopa for more drug crossing blood-brain barrier in smaller dosing

-replace dopamine that is missing

ex: Sinemet

-1:10 ratio

-10/100-25/250 TID (every 8 hrs)

SE: anorexia, dizziness, headache, insomnia

Adverse: palpitations, ortho. hypotension, psychosis, hallucinations, dysrhythmias, agranulocytosis (most important)

-avoid food w/ B6 (pyridoxine)

-controls symptoms, doesn't cure

-stimulate dopamine receptors

ex: Symmetrel, Parlodel, Mirapex, Requip

-dopamine agonist, antiviral

-early Parkinson's, tends to wear off due to resistance

-dopamine agonist

-more effective than symmetrel

-breaks down dopamine

-for early Parkinson's

ex: Eldepryl

-MAO-B inhibitor, caution with MAO-A

-avoid tyramine (banana, aged chs, red wine) --> HTN crisis

-avoid TCA's or SSRI's

-increase dopamine in brain by blocking enzyme COMT

-prolongs effect of L-dopa

ex: Tasmar, Comtan

-COMT inhibitor for advanced Parkinson's

-very hepatotoxic

-monitor for orthostatic hypotension

-administer w/ low protein foods

-avoid B6 and other depressants

-drug dosing at even intervals

-long-term: paranoia, depression, confusion

-incurable, progressive neurodegenerative disorder

-confusion, memory loss, "word-finding", dementia, personality changes

permits moer acetylcholine to the receptors

ex: Cognex, Aricept, Exelon, Namenda, razadyne, hydergine

-for mild-moderate alzheimer's

-improves cognitive function in 30%

10-160 mg/day

-take on empty stomach

-SE: anorexia, depression

-adverse: hepatotoxic

-increased effect w/ Tagamet & theophylline

-monitor VS, esp weight

-monitor motor & cognitive function

-drug doses at even intervals

-monitor LFT's