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NURS 572 Park/Alz
Parkinson's and Alzheimers drug drill
| Question | Answer |
|---|---|
| Parkinson's MOA | too little Dopa, too much ACh --> too much GABA |
| dopaminergic agents to increase Dopa | levodopa - carbidopa |
| what is carbidopa's role | suicide molecule to get levodopa from periphery thru BBB where it can be converted to Dopa |
| what happens if we admin levodopa alone | peripheral decarboxylases degrade it so only 2% can get to brain (10% gets to brain if we combine with carbidopa) |
| two classes of drugs that activate Dopa receptors | ergot derivatives, non-ergot derivatives |
| bromocriptine | ergot derivative |
| non-ergot derivatives are an alternate first line treatment, name these 3 drugs | pramipexole, ropinirole, apomorphine |
| pramipexole | non-ergot dopa receptor activator |
| ropinirole | non-ergot dopa receptor activator |
| apomorphine | non-ergot dopa receptor activator |
| noteworthy feature of 2 drug classes that prevent dopa degradation | COMT inhibitors (peripheral) and MAO-B inhibitors (brain) . . . must have levodopa, carbidopa administered for them to have their actions |
| entacapone | COMT inhibitor in periphery |
| selegiline | MAO-B inhibitor in brain |
| rasagiline | MAO-B inhibitor in brain |
| what drug class is first line for early-PD | drugs that promote Dopa release |
| amantadine | promotes dopa release, first line if early dx |
| what drug class blocks CNS ACh receptors (must cross BBB)so that ACh isn't utilized | anticholinergics |
| name 2 anticholinergics that block ACh receptors in brain | trihexyphenidyl, benztropine |
| what drug class is a 2nd line PD drug | anticholinergics |
| trihexyphenidyl | PD anticholinergic |
| beztropine | PD anticholinergic |
| what must entacapone be administered with to have its effect | this COMT peripheral inhibitor must be admin with levodopa-carbidoba |
| what must selegiline or rasagiline be administered with to have their effect? | these MAO-B inhibitors must be admin with levodopa-carbidopa |
| MAO of Alzheimers | too little ACh, too much glutamate whose abnormal leakage binds NMDA receptor to allow excess Ca in cell --> excitatoxicity that impacts cells in hippocampus, etc. |
| two classes of Alzheimer's drugs | CNS cholinesterase inhibitors (keep ACh), NMDA receptor antagonist |
| name 4 CNS cholinesterase inhibitors | tacrine, donepezil, rivastigmine, galantamine |
| tacrine | cholinesterase inhibitor - hepatotoxic |
| donepezil | cholinesterase inhibitor - drug of choice |
| rivastigmine | cholinesterase inhibitor - bad cholinergic SEs |
| galantamine | cholinesterase inhibitor |
| NMDA receptor antagonist | memantine |
Created by:
lorrelaws
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