Term
|
Definition
Adjunct with Sinemet
unknown mechanism; anti-viral
May cause livodo reticularis (skin looks like when its cold)
avoid patients SEIZURE and HF |
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Term
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Definition
Potent non-selective DA agonist
delivered subcutaneously, rapidly distributed through blood to CNS, benefit in 10 minutes, lasts 2 hours
horrible nausea and very poorly tolerated treat with anti-emetic trimethybenzamide |
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Term
|
Definition
Muscarinic receptor antagonsit: balances ach/DA ratio
may reduce tremor
SE: dry mouth,tachycardia, SOME POTENTIAL FOR ABUSE |
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Term
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Definition
Ergot - Based DA Agonists (D2)
excreted in bile and feces
Do not require metabolic conversion and can be used as monotherpy BUT
HAS OFF TARGET EFFECTS INCLUDING NAUSEA, INSOMNIA, DAYTIME SLEEPYNESS |
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Term
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Definition
Dopa decarboxylase inhibitors
Does not cross BBB
inhibits nausea and cardia effects LDOPA
LDOPA never given without |
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Term
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Definition
Catechol-O-Methyl Transferase (COMT)
Inhibitors: upregulated with use of dopa decarboxylase inhibitors
nausea, orange-colored urine, orthostatic
hypotension, dyskinesia, hallucination, sleep disordersmainly |
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Term
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Definition
L-Dopa; Prodrug dopamine
DA does not cross B3 Even if it did,
peripheral side effects likely intolerable
gold standard works well 1/3, ok 1/3
Clinical efficacy decreases with
time
competes with amino acids for uptake therfore must give 50X needd
2/3 excreted as homovanilla acid urine
GI DISTURBANCES PROFOUND AVOID PROMETHAZINE ANTIEMETIC (abdominal involentary movements)
psycomimetic
DRUG HOLIDAY NOT RECOMMENDED
NO MAOI --> HYPERTENSIVE CRISIS |
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Term
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Definition
partial D3 agonist
Anti-oxidant free radical scavanger
RENAL SECRETION
relief on/off in l-dopa therapy |
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Term
|
Definition
Greatest affinity D2
CYP450 metabolism!
relief on/off in l-dopa therapy |
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Term
|
Definition
selective (at therapeutic doses), irreversible MAOB (targets dopamine) inhibitor
Side effects: mood elevating, nausea, dry mouth, confusion,
adverse reactions with meperidine, TCAs, and SSRIs
MAY REDUCE LIFE SPAN |
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Term
|
Definition
Tremor predominant
occurs approximately 40
more marked impairment first DX
slower cognitive progression |
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Term
|
Definition
Postural imbalance and gait disorder
>70 years old at diagnosis
Akinesia, rigidity, gait/ balance impairment
Rapid decline, cognitive complications more prevalent |
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Term
|
Definition
D1 = excitory
D2 = inhibitory
D2>D1 PD
oldschool ACH>D1 |
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Term
|
Definition
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Term
|
Definition
| carbidopa/l-dopa/entacapon |
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Term
| DA Agonist Adverse Effects |
|
Definition
GI: Anorexia, Nausea, Vomiting, Constipation, Reflux
Esophagitis, Peptic Ulcer Bleeding
Cardiovascular: Postural hypotension, Vasospasm (ergot
agents), Cardiac arrhythmia
Dyskinesia: probably associated with increased L-Dopa
delivery to CNS and/or off-target (non-striatal) effects
Mental disturbance: reports of amplified impulsive behavior
(shopping, gambling, cross-dressing), psychotomimetic at
higher doses
AVOID PERIPHERAL VASCULAR DISEASE |
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