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antiparkinsonian
Ch. 16 Pharm
| Question | Answer |
|---|---|
| What is Parkinson's | chronic, progressive, degenerative disorder, affects dopamine producing neurons |
| what two neurotransmitters are affected and unbalanced | dopamine(SNS) and Ach(PSNS) |
| Where is dopamine stored in brain | substantia nigra |
| when do sx occur with parkinsons | when 80% of dopamine is depleted, need fx nerve terminals that can take up dopamine to manage sx |
| what are classic symptoms of parkinsons | akinesia(masklike), bradykinesia, rigidity(cogwheeling), tremor(pin rolling, 70% cases), postural instability |
| what is levodopa therapy | levodopa turns into dopamine, can x BBB barrier, dopamine can't, control neurotransmitter imbalance, lasts 5-10 yrs, may darken urine or sweat |
| what does on-off phenomenon mean | not enuf dopamine, sx worsen too much dopamine, dsykinesia |
| what are 2 common types of dyskinesia | Chorea- involuntary mvmt of limbs, facial muscles Dystonia- impaired mvmts (michael J Fox) |
| What are some indirect acting dopamine-receptor agonists | MAOB inhibitors: selegiline, rasagiline COMT inhibitors: entacapone, tolcapone Presynaptic dopamine release enhancer: amantadine (antiviral, Flu A) |
| what do MAOIs do, esp Selegiline | break down catecholamines, no "cheese effect" - no incr BP, 50-60% have + therapy, may delay PD for 9 - 18 yrs |
| what are adverse effects of Selegiline | N/V, dizzy, dry mouth may cause HTN in doses higher than 10 mg/day |
| how does amantadine help with PD | block reuptake of dopamine into nerve endings, so more is available for use Used early, helps for 6-12 mos |
| what is adverse effects of Tasmar | severe liver failure "tasmanian devil" mean to liver |
| Adverse effects of direct acting dopamine receptor agonists | Ergot, nonergot drugs, requip(restless leg syndrome), apokyn(SQ injection, newer) |
| Replacement drugs | carbidopa given wtih levadopa "car taxi for leva x BBB" |
| anticholinergic drugs help PD how | treat muscle tremors/rigidity, not relieve bradykinesia, lower Ach levels |
| what are some anticholinergic drugs for PD | Cogentin, treats extrapyramidal sx(tongue tremors), histamines (Benadryl) |
| what are classic ss/sx of PD | mask like expression, speech problems, dysphagia(difficulty swallowing), rigidity of arms, legs, neck |
Created by:
palmerag
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