PD pharm

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Author:
cwhusker
ID:
171012
Filename:
PD pharm
Updated:
2012-11-14 21:28:37
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PD pharm
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Description:
Parkinson's disease
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  1. levodopa
    • MOA: dopamine precursor, must cross the BBB, iron interferes with the effectiveness of the drug
    • USES: PD
    • AE: sedation, insomnia, hallucinations, dyskinesia
    • always given with carbidopa (enzyme to inhibit its breakdown)
  2. entacapone
    • MOA: COMT inhibitor, prevents L-dopa from breaking down, increases cerebral levels of L-dopa
    • USES: helps prevent DA peripheral AE by enhancing L-dopa in the periphery
    • poor BBB penetration, works in the periphery only
  3. selegiline
    • MOA: MAO-B mainly in the brain, prevents the breakdown of DA
    • USES: used in early and late stages, can be used alone or together with L-dopa
    • AE: agitation, insomnia, vivid dreams, may worsen dyskinesia
    • Neuroprotective - slows the progression of the disease
  4. rasagiline
    • MOA: MAO-B, prevents the breakdown of DA and increase the amount of DA in the brain
    • USES: early and late stages of disease
    • AE: aggitation, insomnia, vivid dreams, may worsen dyskinesia
    • Neuroprotective - slow the progression of the disease
  5. bromocriptine
    • dopamine agonst - ergotamines
    • MOA: - D2>D1 agonist
    • USES: used to tx early PD and delay L-dopa, may prevent dyskinesia, acromegaly, fertility control
    • AE: fibrosis and thickening of cardiac valves
    • CI: pts with psychoses/schizophrenia
    • neuroprotective
  6. pergolide
    • dopamine agonist - ergotamines
    • MOA: D2>D1 agonist
    • USES: used to tx early PD and delay L-dopa, may prevent dyskinesia, acromegaly, fertility control
    • AE: fibrosis and thickening of cardiac valves
    • CI: pts with psychoses/schizophrenia
    • neuroprotective
  7. pramipexole
    • dopamine agonist - non-ergotamines
    • MOA: D2>D1 agonist
    • USES: used to tx early PD and delay L-dopa, may prevent dyskinesia, acromegaly, fertility control
    • AE: low BP, nausea, leg swelling, compulsive behavior, sleep attacks
    • CI: pts with psychoses/schizophrenia
    • NEUROPROTECTIVE
  8. ropinirole
    • dopamine agonist - non-ergotamines
    • MOA: D2>D1 agonist
    • USES: used to tx early PD and delay L-dopa, may prevent dyskinesia, acromegaly, fertility control
    • AE:  low BP, nausea, leg swelling, compulsive behavior, sleep attacks
    • CI: pts with psychoses/schizophrenia
    • NEUROPROTECTIVE
  9. rotigotine
    • dopamine agonist - non-ergotamines
    • MOA: stable plasma levels, D3>D2>D1
    • USES: effective in both early and late PD, helpful in non-motor deficits, cognition and pain as well
    • transdermal path
  10. apomorphine
    • dopamine agoinst, non - ergotamines
    • rescue for those freezing movements
    • USES: used in advanced disease, to help with motor fluctuations
    • AE: emesis
    • SC but working on nasal spray
  11. amantadine
    • antiviral/glutamate inhibitor
    • MOA: NMDA receptor antagonist, alters DA release and may alter re-uptake of dopamine
    • USES: reduces PD or L-dopa motor fluctuations and drug induced dyskinesia, accelerates the recovery from severe traumatic brain injury
    • AE: purple rash (levido reticularis)
    • don't use in ppl predisposed to epilepsy or show psychiatric problems
  12. benztropine
    • muscarinic antagonist
    • MOA: anti-cholinergic, capable of hitting DA receptor
    • USES: prescribed to young pts with severe tremor - more effective than L-dopa for this symptom
    • AE: constipation, dry mouth, dry skin

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