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NURS 572 Park/Alz

Parkinson's and Alzheimers drug drill

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