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prototype drug for myasthenia gravis?
main action of cholinesterase inhibitors?
prevents breakdown of acetylcholine. (therefore making it more available)
more specifically - inhibits acetylcholinesterase (which normally breaks down acetylcholine)
two types of cholinesterase inhibitors?
reversible - short-acting effects.
irreversible - longterm effects
undermedicated. lack of ACh causes extreme muscle weakness
what to give for myasthenic crisis?
overmedication of cholinesterase inhibitors. causes extreme muscle weakness
how to diagnose cholinergic vs myasthenic crisis?
- give Tensilon (edrophonium):- worsening symptoms >> cholinergic
- - improvement in symptoms >> myasthenic
what to give for cholinergic crisis?
atropine (overmedicated - reverses effects)
prototype drug for Parkinsons?
pathophys behind parkinsons?
dopaminergic neurons degenerate >> decrease in dopamine >> imbalance of ACh & dopa >> unopposed ACh causes increased amount of GABA >> overactive GABA neurons causes PD symptoms.
types of dopamine replacement therapies
levodopa OR levodopa+carbidopa (Sinemet)
what is the usual first drug selected for mild PD?
- selegiline. (MAO-B inhibitor)
- - suppresses destruction of dopamine; may delay progression of PD
first-line treatment of choice (class) for a patient with more severe symptoms of PD?
- dopamine replacement (levodopa/carbidopa) or
- dopamine agonist
types of dopamine agonists?
- pramipexole (Mirapex)
- bomocriptine (Parlodel)
uses for dopamine agonists? adverse effects?
first-line treatment for PD or supplement to levodopa for more advanced cases
adverse effects: psychological symptoms/hallucinations.
COMT inhibitor prototype? use for COMT inhibitors?
- entacapone (Comtan)
- - prolongs half-life of levodopa.
centrally acting anticholinergics for PD? effects?
- Artane and Cogentin- reduce tremor and rigidity
indications for CNS stimulants?
ADHD or narcolepsy
3 types of amphetamines used clinically