Term
| trihexyphenidyl mechanism |
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Definition
| anticholinergic agent, works because the post-synaptic ACh neuron in PD is overactive when dopamine disappears |
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|
Term
|
Definition
| precursor to dopamine that can cross the BBB; given in combination with carbidopa to prevent nausea/vomiting |
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Term
|
Definition
| enhances release of dopamine, inhibits reuptake of dopamine, blocks NMDA (glutamate) receptors |
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Term
| adverse effects of trihexyphenidyl |
|
Definition
| dry mouth, constipation, confusion in elderly |
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Term
| adverse effects of levodopa |
|
Definition
| involuntary movements in younger patients |
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|
Term
| adverse effects of amantadine |
|
Definition
| hallucinations in elderly but may have neuro-protective qualities |
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Term
|
Definition
| prolongs half-life and increases bioavailability of levadopa |
|
|
Term
|
Definition
ropinerole
agonists at post-synaptic D2 receptors |
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|
Term
|
Definition
selegiline
irreversible inhibitors of presynaptic MAO-B |
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|
Term
|
Definition
entacapone
peripheral inhibitors of COMT - increase half-life of levodopa |
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|
Term
| drugs used in early PD (stages I and II) |
|
Definition
| tremor responds to DA agonists, anticholinergic drugs, amantadine, MAO inhibitors, or levodopa |
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|
Term
| drugs used in late PD (stage III and IV) |
|
Definition
| balance and gait impaired - levodopa is necessary |
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|
Term
| when not to use: Anticholinergic drugs |
|
Definition
| side effects - constipation, confusion, memory problems, hallucinations - more likely in those over 55yrs |
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|
Term
| when not to use: amantadine |
|
Definition
| avoid in renal failure (drug excreted through kidneys)-may develop confusion and hallucinations |
|
|
Term
| when not to use: DA agonists |
|
Definition
| avoid in demented patients - may cause hallucinations, confusion, and sleep attacks |
|
|
Term
| when not to use: levodopa |
|
Definition
| avoid in those under 55 - likely to have levodopa-induced dyskinesias |
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|
Term
| when not to use: MAO-B inhibitors |
|
Definition
| avoid with liver failure (metabolized) |
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|
Term
| when not to use: selegiline |
|
Definition
| avoid using in those with insomnia - amphetamine and methamphetamine are metabolites (take in morning) |
|
|
Term
| when not to use: COMT inhibitors |
|
Definition
| avoid in those with incontinence - pink urine and diarrhea are side effects |
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|
Term
| when not to use: tolcapone |
|
Definition
| liver failure in those with liver disease |
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