Term
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Definition
transported into CNS, converted to dopamine |
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Term
What are the peripheral dopaminergic effects of levodopa? |
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Definition
anorexia, nausea, vomiting, cardiac arrhythmias, postural hypotension, hypertension, dyskinesias, changes in mood or personality, mydriasis, etc |
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Term
why isn't levodopa always used as first drug in Parkinson's disease? |
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Definition
development of disabling response fluctuations over time |
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Term
Name the drug: 6-8 effect, tox: GI upset, arrhythmias, dyskinesias, on-off, behavioral disturbances |
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Definition
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Term
What drug diminishes the dosage of levodopa required? Which drugs prolong the duration of effect? |
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Definition
carbidopa, COMT or MAO-B inhibs |
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Term
Does carbidopa enter the CNS? |
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Definition
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Term
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Definition
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Term
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Definition
levodopa, carbidopa and entacapone |
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Term
Which drug is a direct agonist at D3 receptors? Is it an ergot? |
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Definition
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Term
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Definition
reduces symptoms of park's, smooths out fluctuations in levodopa response |
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Term
pramipexole: clinical applications? |
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Definition
park's, initial therapy or for on-off phenomenon |
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Term
How is pramipexole taken? What is the DOA? Tox? |
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Definition
orally, 8 hrs, nausea, vomiting, postural hypotension, dyskinesias |
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Term
Ropinirole is similar to which other drug? What is the MOA? Is it an ergot? |
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Definition
pramipexole, relatively pure D2 agonist, nonergot |
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Term
Bromocriptine is a potent agonist at ___ receptors |
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Definition
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Term
Name an ergot derivative that is an agonist at D2 |
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Definition
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Term
How does the toxicity of bromocriptine compare to pramipexole or ropinirole? |
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Definition
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Term
Is apomorphine an ergot derivative? What is it used for? There is a high incidence of which side effects? what is the MOA? |
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Definition
no, subcutaneous route useful for rescue treatment in levodopa-induced dyskinesia, nausea and vomiting, it is a potent dopamine agonist |
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Term
What are pramipexole, ropinirole, bromocriptine and apomorphine? |
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Definition
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Term
Name the dopamine agonists |
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Definition
pramipexole, ropinirole, bromocriptine, apomorphine |
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Term
What are rasagiline and selegiline? |
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Definition
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Term
name 2 MAOIs used in movement disorders |
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Definition
rasagiline and selegiline |
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Term
What is the MOA of rasagiline? |
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Definition
inhibits MAO-B selectively, higher doses also inhibit MAO-A |
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Term
Which drug inhibits MAO-B, and at higher doses also inhibits MAO-A? |
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Definition
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Term
What are the effects of rasagiline? |
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Definition
increases dopamine stores in neurons, may have neuroprotective effects |
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Term
Clinical applications for rasagiline? |
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Definition
park's, adjunctive to levodopa, smooths levodopa response |
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Term
How is rasagiline taken? Toxicity and interactions? |
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Definition
orally, may cause serotonin syndrome with meperidine, theoretically also with SSRIs and TCAs |
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Term
Selegiline is like which other drug? May be less potent in what situation? |
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Definition
rasagiline, MPTP-induced park's |
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Term
Which drugs used for movement disorders could cause serotonin syndrome with SSRIs, meperidine, or TCAs? |
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Definition
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Term
Name 2 COMT inhibitors used in movement disorders |
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Definition
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Term
what are entacapone and tolcapone? |
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Definition
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Term
What is the MOA of entacapone? |
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Definition
inhibits COMT in periphery, does not enter CNS |
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Term
which drug inhibits COMT in the periphery? |
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Definition
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Term
What are the effects of entacapone? |
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Definition
reduces metabolism of levodopa and prolongs action |
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Term
Which drug reduces the metabolism of levodopa and and prolongs its action? |
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Definition
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Term
clinical applications for entacapone? |
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Definition
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Term
How is entacapone taken? Toxicity? |
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Definition
orally, increased levodopa toxicity, nausea, dyskinesia, confusion |
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Term
Tolcapone is like which other drug? Does it enter the CNS? Tox? |
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Definition
entacapone, YES it enters the CNS, some evidence of hepatotoxicity and elevation of liver enzymes |
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Term
Which drug enters the CNS to inhibit the metabolism of levodopa? |
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Definition
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Term
Name some antimuscarinic agents used in movement disorders |
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Definition
benztopine, biperiden, orphenadrine, procyclidine, trihexyphenidyl |
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Term
What kind of drugs are these: benztopine, biperiden, orphenadrine, procyclidine, trihexyphenidyl |
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Definition
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Term
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Definition
antagonist at M receptors in basal ganglia |
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Term
Which drug is an antagonist at M receptors in basal ganglia? |
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Definition
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Term
what are the effects of benztropine? |
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Definition
reduces tremor and rigidity, little effect on bradykinesia |
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Term
Which drug reduces tremor and rigidity but has little effect on bradykinesia? |
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Definition
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Term
clinical application for benztropine? |
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Definition
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Term
how is benztropine taken? Toxicity? |
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Definition
orally, antimuscarinic effects: sedation, mydriasis, urinary retention, dry mouth |
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Term
Name some drugs used in Huntington's disease |
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Definition
tetrabenazine, reserpine, haloperidol |
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Term
tetrabenazine, reserpine and haloperidol are used in which situation? |
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Definition
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Term
What is the MOA of tetrabenazine and reserpine? |
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Definition
depletes amine transmitters, especially dopamine, from nerve endings |
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Term
which drugs deplete amine transmitters, especially dopamine, from nerve endings |
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Definition
tetrabenazine and reserpine |
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Term
what are the effects of tetrabenazine and reserpine? |
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Definition
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Term
How are tetrabenazine and reserpine taken? Toxicity? Which is somewhat less toxic? |
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Definition
orally, hypotension, sedation, depression, diarrhea, tetrabenazine is somewhat less toxic |
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Term
which drugs can cause hypotension, sedation, depression and diarrhea? |
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Definition
reserpine and tetrabenazine |
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Term
Which drugs are used in Tourette's? |
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Definition
haloperidol, clonidine, phenothiazines, benzodiazepines, carbamazepine |
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Term
haloperidol, clonidine, phenothiazines, benzodiazepines and carbamazepine are sometimes used for... |
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Definition
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Term
What is the MOA of haloperidol? |
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Definition
blocks central D2 recepts |
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Term
which drug blocks central D2 recepts? |
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Definition
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Term
What are the effects of haloperidol in Tourettes? |
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Definition
reduces vocal and motor tic frequency and severity |
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Term
How is haloperidol taken? Toxicity? |
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Definition
orally, parkinsonism, other dyskinesias, sedation |
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Term
Clonidine is effective in about __% of Tourette's pts |
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Definition
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Term
Which drugs are "sometimes of value" in Tourettes? |
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Definition
phenothiazines, benzos, carbamazepine |
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Term
What is the preferred tx for RLS? |
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Definition
dopaminergic therapy - pramiprexole or ropinirole |
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Term
adverse effect of antipsychotics, reserpine at high doses, and MPTP (by-product of illicit meperidine analog) and is irreversible |
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Definition
Drug induced Parkinsonism |
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Term
Anti-Parkinson's drug which increases intraocular pressure and is contraindicated in closed angle glaucoma |
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Definition
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Term
Ergot alkaloid that is a partial agonist at D2 receptors in the brain, used for patients who are refractory or cannot tolerate levodopa, causes erythromelalgia |
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Definition
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Term
What is the weird toxic effect of bromocriptine? |
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Definition
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Term
Enhances dopaminergic neurotransmission, SE's include CNS excitation, acute toxic psychosis and livedo reticularis |
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Definition
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Term
What does amatadine do? side effects? |
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Definition
Enhances dopaminergic neurotransmission SE's include CNS excitation, acute toxic psychosis and livedo reticularis |
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Term
Agent effective in physiologic and essential tremor |
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Definition
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Term
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Definition
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Term
Chelating agent used in Wilson's disease |
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Definition
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