levodopa

(L-dopa)

class: dopamine precurser (enters CNS)

mech: direct precurser, enters CNS and is converted to dopamine by DOPA decarboxylase

SE- Peripheral- nausea, vomiting, orthostatic hypotension, cardiac arrhythmia

Central- dyskinesia, mydriasis(glaucoma)

mech: peripheral DOPA decarboxylase inhibitor

function: by preventing conversion into dopamine in the periphery, more L-dopa makes it into CNS

sinemet

(parcopa)

L dopa + carbidopa

more central SE, less peripheral

parcopa- chewable

bromocriptine

pergolide

Class: direct dopamine agonist

nonselective

pergolide TX: valvular heart disease

ropinirole

pramipexole

class: direct dopamine agonist

D₂ selective

class: parenteral dopamine agonist

(vomit!) rescue drug

selegiline

rasagiline

class: monoamine oxidase inhibitor

MAOI

selective for MAO-B(rain)

function: inhibit dopamine inactivation in the CNS

tx: do NOT give w/ meperidine (demerol)

entacapone

tolcapone

class: catechol-O-methyltransferase inhibitor

(COMT inhibitor)

function: stops dopamine and L-dopa inactivation by COMT.

entacapone- periphery only

tolcapen-both but severely hepatotoxic

combo of

L-dopa

carbidopa

entacapone

benztropine

biperiden

trihexyphenidyl

class: muscarinic blocker

effect: decrease rigidity and tremor

SE- dry mouth

Class: antiviral

thought to alter release and reuptake of dopamine

limited time use

class: alzheimers drug

mech: ACHE inhibitor

tx: severe hepatotoxicity

donepezil

rivastigmine

galantamine

class: alzheimers

mech- ACHE inhibitor

class: amyotrophic lateral sclerosis

(Lou Gehrig's)

mech: glutamate presynaptic release and postsynaptic receptor blocker