pharm park

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  1. 4 selective serotonin reuptake inhibitors (antidepressants)
    • Fluoxetine (Prozac)
    • Sertraline (Zoloft)
    • Paroxetine (Paxil)
    • Citalopram (Celexa)
  2. Fluoxetine is what?
    selective serotonin uptake inhibitor - antidepressant
  3. sertraline is what?
    selective serotonin uptake inhibitor - antidepressant
  4. paroxetine is what
    selective serotonin uptake inhibitor - antidepressant
  5. citalopram is what
    selective serotonin uptake inhibitor - antidepressant
  6. celexa is what
    selective serotonin uptake inhibitor - antidepressant
  7. akathesia
    • invol movements
    • slow
    • loss
    • can't initiate mvmnt
  8. neurotransmitter changes seen in PD
    • less: dopamine, serotonin, GABA, norepinephrine
    • more: acetylcholine (relatively speaking)
  9. sinemet
    combo of levodopa and carbidopa
  10. levodopa does what? taken with what
    • converts to dopamine
    • taken with carbidopa which helps levodopa reach the BBB without breaking down (so the pt can take lower doses of levodopa and avoid the NV side effects of larger doses)
  11. MAO inhibitors -- mechanism
    monoamine oxidase (MAO) catabolizes catacholamines (dopamine, norepinephrine, epinephrine, serotonin) so MAO inhibitors blocks this

    target MAO B bc that's in the brain, while MAO A is intestinal
  12. best known MAO
  13. selegine - what is it? how is it used?
    • MAO inhibitor
    • served w levodopa/carbidopa (sinemet) so you won't have to take as much l/c

    also, its metabolites (amphetamine and methamphetamine) enhance release of norepinephrine, dopamine, serotonin
  14. 3 names for MAO inhibitors
    • selegiline
    • eldepryl
    • juprenil
  15. COMT inhibitors -- catechol o-methyltransferase does what?
    help levodopa reach brain more safely (slows its breakdown) and limit the "off" periods
  16. COMT inhibitor names
    • tolcapone (tasmar)
    • entacapone (comtan)
    • stalevo -- combo of levadopa, carbidopa, and entacapone
  17. tolcapone/tasmar - type of drug? side effects?
    • COMT inhibitor
    • liver failure
  18. stalevo
    combo of leva/carbidopa and entacapone
  19. amantadine does what
    augments dopamine release from presynaptic neurons and inhibits reuptake into storage granules
  20. amantadine - useful for what symptoms
    stiffness, slowness, rigidity, bradykinesia
  21. amantadine side effects
    • GI - N/V dry mouth, diarrhea
    • CNS - depression, hallucinations, confusion, insomnia, irritability
    • CV - edema, orthostatic hypotension
  22. dopamine agonists - name
    • ropinirole (requip)
    • pramipexole (mirapex)
    • bromocriptine
  23. how do dopamine agonists work?
    they act like dopamine and stim their receptors

    can be used indep in early stages of PD (to delay the need for levodopa), used w levodopa in advanced PD
  24. when to add dopamine agonists to levodopa?
    • levodopa can't control symptoms and increasing the dose would be reckless
    • severe motor fluctuations
  25. side effects of dopamine agonists
    all the usual bad stuff
  26. anticholinergic meds
    Maintain balance of dopamine and acetylcholine by breaking down ACh. 

    Main role is to diminish tremor.  Also helps with muscle rigidity. 

    Not so effective w bradykinesia and postural disturbances
  27. anticholinergic side effects
    • PNS - dry mouth, blurred vision, constipation, urinary retention, increased intraocular pressure
    • CNS - confusion, mem impairment, hallucinations, delusions
  28. deep brain stim for PD stims what?
    • subthalamic nucleus
    • this jams//blocks abnormal circuitry to minimize the disabling symptoms
    • used for pts who can't be managed by meds
  29. ropinirole/requip is what
    dopamine agonist
  30. pramipexole / mirapex is what
    dopamine agonist
  31. bromocriptine is what?
    dopamine agonist
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pharm park
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