Parkinson Pharmacology
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- What are the goals of pharmacotherapy of PD?
- replace DA or modulate NT systems regulated by dopaminergic input
- What symptoms of PD?
- Resting tremor, bradykinesia, rigidity (masked facies), postural defects
- What is the function of the nigrostriatal system?
- motor behaviors
- What is the function of the mesolimbocortical system?
- learning, memory, emotions, affect, reward (degenerates in some PD)
- What is the function fo Hypothalamo-hypophyseal system?
- inhibiting prolactin secreation (not affected in PD
- What is the function of the chemoreceptor Trigger zone?
- DA receptor activation in the area postrema inuces nausea and vomiting
- What happens when you lose DA neurons?
- up-regulation of striatal DA receptors, disinhibition of indirect pathway, dysfacilitation of direct pathway
- What is L-Dopa?
- it is DA precusor used because DA can't cross BBB
- What is Carbidopa?
- is a peripheral dopa-decarboxylase inhibitor
- What are L-dopa and Carbidopa used for?
- 67% effective for PD, elevation of growth hormone release, and hyperprolactinemia
- What the oral bioavailability of L-dopa?
- 20-30%, but that is in the periphery
- What are the side effects of L-dopa and carbidopa?
- dykinesias, crazy psych problems, N/V
- What are Bromocriptine, ropinerol, pramipexole?
- DA receptor agonist D2, D2, D3
- What are the uses for bromocriptin, ropinerol, pramipexole?
- PD, hyperprolactinemia
- What is the oral bioavailability of bromocriptin, ropinerol, pramipexole?
- 94% and it is highly bound to albumin
- What are the side effects of bromocryptine?
- anorexia, n/v, HoTN, cardiac arrhythmias, dykinesias, psych issues, colicky abdominal pain, constipation, blurred vision
- What is Amantadine?
- It is a DA releaser
- What is selegilin?
- MAO-B inhibitor
- What is selegilin broken down into?
- amphetamine
- What is talcopone?
- COMT inhibitor--dangerous to your liver
- What is Entacapone?
- COMT inhibitor--improves off-time
- What is benztropine?
- Anticholinergic agent
- What are the ADR of benztropine?
- cycloplegia, mydriasis, dry mouth, urinary retention