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- Amantadine - contraindications
- Renal impairment, chf, orthostatic hypotension, edema, sz disorder, psychosis, dermatitis
- Entacapone - action
- Inhibits dopamine metabolism
- Barbituartes - adverse affects
- Sedation, dizziness, lethargy, cognitive impairment, behavioral changes, tolerance, dependence, dermatitis, Stevens Johnson's Syndrome
-
anamtadine - clinical uses
- Parkinsons, influenza A prophylaxis and tx.
- SSRI - contraindications
- within 14 days of MAOI use. Avoid abrupt withdrawal. Impaired renal or liver function. Suicidal pts.
- Hydantions - Mechanism of action
- INhibits and stabilizes electrical discharges. Raises sz threshold.
- Pramipexole - adverse affects
- Dizziness, somnolence, drowsiness, hallucinations, hypotension
- Bromocriptine - clinical uses
- Parkinson's, hyperprolactinemia, acromegaly
- Barbiturates - Clinical uses
- sz, status epilepticus, febrile sz, sedative
- Pramipexole - clinical uses
- Parkinsons
- Entacapone - drug interactions
- Dobutamine, methyldopa, isoproterenol, TCA's, MAOI's, sedatives, dopamine antagonists, erythromycin, ampicillin, cholestyramine
- SSRi pharmacokinetics
- Thoroughly absorbed PO. Metabolized in liver. Excreted via kidneys. Onset of respones = 3-6 weeks. Long 1/2 life.
- Succinimides - clinical uses
- absence sz - DOC
- Barbiturates - drug interactions
- Cytochrome P450 enzyme involvement. CNS depressants, acetaminophen, anticoagulants, OCP, TCA's, antibiotics
- Amantadine - side effects
- Dizziness, anxiety, impaired coordination, restlessness, irritability, confusion, hellucinations, depression, orthostatis hypotension, edema, enaorxia, xerostomia
- Succinimides - contraindications
- Pregnancy class C. Lactation, liver problems, blood dyscrasias
- Tolcapone - contraindications
- Driving, hepatic disease, hypotension, sycnope, diarrhea, hematuria
- Succinimides - adverse affects
- N&V, lethargy, sedation, dizziness
- Benzodiazepine - mechanism of action
- Increase action of GABA, decreasing the effect of neuronal excitation.
- Succinimides - drug interactions
- CNS depressants, etoh, hydantoins, OCP
- Pramapexole - Drug interactions
- Dopamine antagonists, cimetidine
- SSRI - mechanism of action
- Selective action against serotonin pump (5ht transporter). Blocks reuptake of serotonin
- Pramipexole - contraindications
- Caution while driving. Caution with hypotension and renal insufficiency
- Entacapone - clinical uses
- Parkinson's
- Barbiturates - contraindications
- Pregnancy class D. Renal and liver failure, heart problems, chronic respiratory disease
- Stimulants - Clinical uses
- ADHD
- Succinimides - example
- Ethosuximide
- Hydantions - adverse effects
- Gingival hyperplasia, nystagmus, confusion, hirsutism, hypotension, neuropathy, sedation, teratogenesis
- Ropinirole - actions
- Stimulates dopamine receptors. Non-ergot dopamine agonist that acts on D2 and D3 receptors
- Bromocriptine - action
- Stimulates dopamine receptors - ergot alkaloid that is a D2 agonist. Growth hormone stimulant.
- Entacapone - adverse affects
- Dizziness, sedation, confusion, hallucinations, diarrhea, abd pain, hypotension, syncope, hematuria, elevated hepatic enzymes
- Benzodiazepines - examples
- Diazepam, clonazepam, lorazepam, chlordiazepoxide
- Hydantions - Uses
- Sz, Prophylaxis for status epilepticus, arrythmias
- Ropinirole - drug interactions
- Cimetidine, cipro, clarithromycin, diltiazem, erythromycin, fluvoxamine, omeprazole, ritonavir, carbamezepine, phenobarb, dilantin, dopamine antagonists
- Valproates - adverse affects
- N&V, weight gain, sedation, ataxia, tremor, hepatotoxicity
- Benzodiazepines - clinical uses
- Status epilepticus (diazepam is DOC), absence sz, acute etoh withdrawal, anxiety (short term)
- Ropinirole - clinical uses
- Parkinsons
- Benzodiazepines - adverse affects
- Drowsiness, lethargy, respiratory and cardiovascular depression
- Stimulants - contraindications
- Pregnancy, lactation, glaucoma, Tourette's syndrome, anxiety, MAOI, CV disease, hypertension, sz, hyperthyroidism, alcohol/drug abuse
- Bromocriptine - adverse affects
- Hypotension, confusion, hallucinations, dyskinesias, N&V, constipation, anorexia
- SSRI - clinical uses
- Depression, OCD, bulimia nervosa, panic, anxiety, PTSD, premenstrual dysphoric disorder
- stimulants - drug interactions
- MAOI's (hypertensive reaction), SSRI (increase serum concentration of SSRI's)
- Benzodiazepines - contraindications
- Pregnancy, lactation, hepatic and renal disease, acute closed angle glaucoma, dependancy
- Benzodiazepines - drug interactions
- CNS depressants, barbiturates, etoh, antihistamines, neuroleptics, TCA's, digitalis
- Hydantions - Examples
- Phenytoin, fosphenytoin
- Ropinirole - adverse affects
- Diaphoresis, flushing, xerostomia, dizziness, drowsiness, hyperesthesia, restlessness, vertigo, hypotension, a-fib, s. tach, syncope, abd pain, flatulence
- Succinimides - mechanism of action
- Suppression of motor cortex, inhibition of stimuli. Decreases sz threshold.
- Hydantions - Drug interactions
- Cytochrome P450 enzyme involvement. Tagamet, antabuse, etoh, salicylates, valporic acid, rifampin, antacids, tegretol, estrogens, haldol, steroids, dopamine, lasix
- SSRI - drug interactions
- Other sertonergics, ergotamine, MAOI's, valporate, carbamazepine, TCA's, benzodiazepines
- Bromocriptine - drug interactions
- CYP3A4 enzyme substrate agents (erythromycin, protease inhibitors), amiutryptiline, imipramine, methyldopa, phenothiazines, reseprine, ergot alkaloids
- Valproates - examples
- Valporic acid (depakote, depacon)
- SSRI adverse affects
- Serotonin syndrome (N&V, diarrhea, chills, sweating, hyperthermia, hypertension, cyocolinc herking, agitation, ataxia, disorientation, cofusion, delium - leads to coma or death).. Common affects - insominia, H/a, fatifue, anorexia, decreased libido, delayed ejacuation, impotence
- Hydantions - contraindications
- Pregnancy category C. Cardiad problems, hypotension, liver damage
- Valproates - mechanism of action
- Increases action of GABA
- Entacapone - contraindications
- Driving, hepatic disease, hypotension, sycnope
- Valproates - clinical uses
- Absence, mixed, myoclonic, generalized sz, bipolar disorder
- Levo/carbodopa - clinical uses
- Parkinson's
- Valproates - drug interactions
- Phenobarb, phenytoin, carbamazepine, CNS depressants
- SSRI - class
- antidepressants
- Valproates - contraindications
- Pregnancy class D (associated with spina bifida), liver disease, bleeding disorders, renal impairment.
- Tolcapone - drug interactions
- dobutamine, methyldopa, isoproterenol, TCA's, MAOI's, sedatives, dopamine antagonists
- MAOI - examples
- Nardil, parnate
- TCA- class
- antidepressants
- ropinirole - contraindications
- Caution with driving. Syncope, hypotension, hepatic disease, psychosis
- Stimulants - examples
- Methylphenidate (ritalin, methylin, metadata, concerta)
- What are the three things anti-parkinson drugs do?
- 1. Increase dopamine levels (levodopa plus carbidopa)
2. Stimulate dopamine receptors (bromocriptine, pergolide, pramipexole, ropinirole)
3. Inhibit dopamine metabolism (selegiline, topcapone, entacapone)
- Selegiline - clinical uses
- Parkinson's
- Pergolide - action
- Stimulates dopamine recpetors. Semi-synthetic ergot alkaloid. D1 and D2 agonist. 10x more powerful than bromocriptine.
- Barbiturates - mechanism of action
- Ingibits GABA receptors. Causes membrane hyperpolarization, and decrease in neuronal excitability. Increases sz thershold.
- TCA - examples
- amitriptyline, clomapramine, imipramine, protriptyline, desipramine, doxepin, nortriptyline, trimipramine
- Pergolide - clinical uses
- Parkinson's
- Selegiline - action
- Inhibits dopamie metabolism. Non-competetive antagonist of MAO type B (oxidizes dopamine in the brain)
- TCA - uses
- depression, ocd, enuresis in kids, anxiety, chronic pain
- MAOI - class
- antidepressant
- TCA - mechanism of action
- Blocks serotonin and norepi reuptake pumps. BLocks muscarinic cholinergic, histamine and alpha 1 adrenergic receptors
- TCA - phramacokinetics
- Thoroughly absorbed PO. Metabolized in liver excreted via kidneys. 1/2 life average = 24-36 hours. 2-4 weeks before remission of symptoms
- TCA - drug interactions
- CNS depressants, SSRI's, Ca channel blockers, propoxyphens, OCP, anticholinergics, carbamazepine, phenytoin, MAOI's, clonidine, cannabis
- TCA - adverse affects
- dry mouth, constipation, weight gain, urinary hesitancy, gynecomastia, libido changes, hypotension, sedation
- Stimulants - mechanism of action
- Prevents reuptake of dopamine, serotonin, and norepi in the presynaptic nerve endings. Stimulates the brain stem and cerebral cortex.
- Seligiline - drug interactions
- MAOI's, TCA's, fluoxetine, SSRI's, meperidine, serotonin receptor agopnists, COP, tramadol, tyramine
- Selegiline - adverse affects
- Confusion, hallucinations, loss of balance, insomnia, dyskinesia, labile emotions, hypotension, cyncope, dysphagia, dyspepsia, peripheral edema, urinary retention
- Levodopa plus carbidopa - action
- Increases dopamine levels. Rapidly converts to dopamine in PNS and CNS. Crosses blood brain barrier.
- TCA - contraindications
- cardiovascular disease (recent MI), glaucoma, prostate hypertrophy, MAOI's, pregnancy, sz, impaired liver function. Caution with children, elderly and suicidal pts, even more so than with SSRI's
- SSRI - examples
- prozac, sarafem, paxil celexa, zoloft, luvox, lexapro
- Levo/carbodopa - side effects
- Anorexia, N&V, constipation, dyskinesia, involuntary movements, tachycardia, orthostatic hypotension, arrythmias, confusion, nightmares, anxiety
- Barbiturates - examples
- Phenobarbital
- Pergolide - drug interactions
- Dopamine antagonists, phenothiazines, droperidol, metoclopramide
- MAOI - adverse affects
- Abrupt discontinuation - withdrawal. Insomnia, anxiety, agitation, dryu mouth, urinary retention, decreased sexual function.
- Amantadine - drug interactions
- Dopamine antagonists, anticholinergics, TCA, sedating anti-histamines, triamterine, hctz
- MAOI - mechanism of action
- inhibits MAO which metabolizes norepi, serotonin and dopamine. This increases bioavailabity of these neurotransmitters
- MAOI - phramacokinetics
- rapidly and thoroughlly absorbed PO. Metabolized i liver and excreted via urine. Relief of symptoms in 14 days.
- Levo/carbidopa - drug interactions
- Pyridoxine (vitamin B-6), dopamine antagonists, MAOI's
- MAOI - clinical uses
- Not commony used due to drug interactions and side effects. Can be used for refractory unipolar dipression, bulimia.
- Pergolide - adverse affects
- Diskinesias, dystonic reactions, hallucinations, drowsiness, anxiety, insomnia, hypotension, palpitations, abd pain, constipation, anorexia
- Stimulants - pharmacokinetics
- Metabolized in the liver, excreted in kidneys
- Amantadine - action
- Increases dopamine levels. Anti-viral agent that blocks dopamine uptake
- Bromocriptine - contraindications
- Severe ischemic heart dis4ease, peripheral vascular disorders, pregnancy
- Stimulants - adverse affects
- Insominia, restlessness, irritability, euphoria, h/z, dizziness, anorexia, abd pain, weight loss, tachycardia, blood pressure changes, growth supression (temporary)
- Pramipexole - actions
- Stimulates dopamine receptors. Non-ergot dopamine agonist that binds to D2 and D3 receptors in the substantia nigra
- Tolcapone - adverse affects
- Dizziness, sedation, confusion, hallucination, diarrhea, anorexia, hypotension, syncope, hematuria, elevated hepatic enzymes
- MAOI - drug interactions
- Anticholinergics, sympathomimetics, stimulants, foods with tyramine, SSRI's, CNS depressants, antihypertensives, diuretics, meperidine, TCA"s, OTC cold medicines
- Levo/carbidopa - contraindications
- Glaucoma, MI, arrythmias, astham, PUD
- Pergolide - contraindications
- Hypotension
- Seligiline - contraincications
- PUD, dementia, tardive dyskinesia
- Tolcapone - actions
- Inhibits dopamine metabolism. Selective and revensibke ingibitor of catechol-o-methyltrnasferase (metabolizes catecholamines). Leads to sustained plasma levels of levodopa to cross into CNS
- Tolcapone - clinical uses
- Parkinson's
- MAOI - contraindications
- Liver and kidney disease, CHF, atherosclerotic disease, >60 y/o, SSRI use, buproprion use, general anesthesia, children, pregnancy category C
- MAOI - contraindications
- Liver and kidney disease, CHF, atherosclerotic disease, >60 y/o, SSRI use, buproprion use, general anesthesia, children, pregnancy category C
