Movement Disorders Drugs

Random Miscellaneous Quiz

Can you name the Movement Disorders Drugs?

Quiz not verified by Sporcle

embed
 plays        
How to Play
HintAnswer
Carbidopa class
Tolcapone class
Group P-kinetics: Advantages: No enzymatic conversion required, crosses BBB w/o competing for amino acid transporter. No potentially toxic metabolites
Use: Huntington's dz pts w/ psychosis or disruptive behavior. Also helpful w/ chorea
Apomorphine class
SE: Ergoline-induced toxicity effects unlikely. Postural hypotension, fatigue, somnolence, peripheral edema, nausea, constipation, dyskinesias, & confusion.
P-kinetics: Only 1-3% enters the brain across BBB unaltered. Peak plasma levels 1-2 hrs post PO dose. Plasma t1/2 = 1-2 hrs (pts vary -- dosing 3-4x/day).
SE: Nausea (pretreat w/ anti-emetic - trimethobenzamide or domiperidone), dyskinesias, drowsiness, sweating, hypotension
Rasagiline class
Butyrophenones class
P-kinetics: Note: Antidepressant MAOIs are either nonspecific or inhibit MAO-A more specifically (5-HT & NE)
Interactions: Vitamin B6 enhances the extracerebral metabolism of L-dopa. MAOI w/ L-dopa can --> HTNive crisis if given within 2 weeks of each other.
SE: CNS: drowsiness, mental slowness, inattention, restless, confusion, agitation, delusions, hallucinations, & mood changes.
Biperiden class
Levodopa class
SE: GI: anorexia, n/v, constipation, dyspepsia, peptic ulcers, symptoms of reflux esophagitis. CV: postural hypotension & cardiac arrhythmias. Dyskinesias.
Riluzole class
MOA: Increases dopamine release & reduces dopamine reuptake into dopaminergic nerve terminals of substantia nigra neurons. Unknown MOA.
MOA: D2 receptor agonist (partial D1 agonist)
Orphenadrine class
Contraindications: psychotic pts, angle closure glaucoma (Increased IOP), active peptic ulcers, hx of melanoma (melanin precursor)
SE: If adverse effects become too severe withdraw gradually. break for 3-21 days, and reinstate gradually
Contraindications: psychotic illness, MI hx, PVD, peptic ulcers
P-kinetics: 2/3 appears in urine as metabolites within 8 hrs (homovanillic acid - HVA and dihydrocyphenylacetic acid - DOPAC). Best response is in the first few yrs of tx.
SE: CV: Increased HR, PVCs, A fib (rare), postural hypotension, HTN (usually in the presence of non-specific MAOI or with large doses).
MOA: Somewhat selective MAO-B inhibitors. Retard the breakdown of dopamine
Carbamazepine class
TCA class
Use: May improve tremor & rigidity in Parkinsons. Little effect on bradykinesia.
Ropinirole class
Use: Temporary relief of off-period akinesia in Parkinsons. Also used to tx ED.
P-kinetics: Start at low dose & gradually increase
HintAnswer
MOA: D1 and D2 receptor agonist
Use: Gold standard in Parkinson's dz - most efficacious treatment
P-kinetics: Similar to Pramipexole
MOA: Preferential affinity for D3 family of receptors
Bromocriptine class
Use: depression associated with Huntington's disease
Use: Similar to Pramipexole
P-kinetics: Well absorbed orally. T1/2 ~ 12 hrs. Hepatic metabolism (cytochrome P450, CYP1A2) -- caution in pts w/ hepatic insufficiency.
Haloperidol class
Clonazepam class
Olanzapine class
Contraindications: Prostatic hyperplasia, obstructive GI dz, & angle-closure glaucoma
SE: Mental Disturbances: confusion, hallucinations, delusions, other psychiatric reactions.
P-kinetics: Response can decline over time or stop completely. Start at small dose & escalate as effects diminish. Wearing off rxs. Toxicity concern is supersensitivity develpmnt -
P-kinetics: Rapid PO absorption, excreted unchanged in urine, gradually increase dose
SE: May be hepatotoxic - (needs signed pt consent & liver monitoring Q 2 wks x 1 yr)
Entacapone class
Use: Most effective drug in tx of Tourette's
SE: Increased L-dopa toxicity (dyskinesias, nausea, & confusion), diarrhea, abd pain, orthostatic hypotension, sleep disturbances, & orange urine.
Use: Enhance & prolong the effects of L-dopa; reduce response fluctuations; lowers necessary dose of L-dopa. ?Antioxidant properties?
Trihexyphenidyl class
Pramipexole class
SE: Dyskinesias: chorea, ballismus, athetosis, dystonia, myoclonus, tics, tremors. Behavioral effects: anxiety/ agitation, insomnia/ somnolence, confusion/ delusions/ hallucination
Use: Similar to Bromocriptine, but more effective. May benefit pts not receiving L-dopa. Aids pt w/ response fluctuations to L-dopa
Procyclidine class
Use: Monotherapy for mild Parkinsonism or combo tx for advanced pts. Reduces L-dopa dose & smooths response fluctuations. Putative neuroprotective effects (scavenges free radicals)
MOA: Inhibits the L-dopa --> dopamine conversion by dopa decarboxylase in the periphery (does not cross BBB).
Reserpine class
MOA: Pure D2 receptor agonist
MOA: Prevents the metabolism of L-dopa --> 3-O-methyldopa (3OMD) by Catechol-0-methyltransferase
Pergolide class
Risperidone class
HintAnswer
Use: Reduced response to fluctuations w/ L-dopa. Decreased L-dopa clearance. Decreased dopa decarboxylase --> compensatory increase in COMT.
Benzotropine class
P-kinetics: Only helpful for Huntington's dz chorea at very high doses
Use: Increases amount of L-dopa able to cross the BBB. Combo with L-dopa allows for L-dopa dose reduction up to 85%.
Carbidopa + levidopa (1:10 or 1:4)
SE: Insomnia when taken late in the day
SE: May interfere with uptake - Rx metabolizes L-dopa into 3-methyldopa which competes for active transport across the BBB.
Use: alleviation of chorea
Amantadine class
SE: Other: dry mouth, blurred vision, mydriasis, urinary retention, n/v, constipation, tachycardia, increased IOP.
SE: HA, nasal congestion, increased arousal, pulmonary infiltrates, ergoline-induced s/s, erythromelagia, vasospasm, & pleural or retroperitoneal fibroses.
P-kinetics: Given PO. Loses effectiveness over time.
P-kinetics: SQ. Rapid onset ~ 10 min. Duration 2 hrs
SE: Asthenia, dizziness, GI disorders, & elevation of liver enzymes.
SSRI class
SE: GI (L-dopa alone): anorexia, n/v (avoid anti-emetics like phenothiazines d/t their extrapyramidal effects -- dopamine antagonist; carbidopa reduces these effects.
P-kinetics: Start with a small dose
Phenothiazine class
Selegiline class
Interactions: Should not be taken w/ meperidine, TCAs, serotonin reuptake inhibitors, or in combo w/ nonspecific MAOIs
P-kinetics: Variable absorption from GI, peak plasma levels 1-2 hrs post PO dose. Excreted in bile & feces. Build up dose slowly over 2-3 mo to avoid adverse effects
Quetiapine class
Clonidine class
MOA: Dopamine precursor able to cross the BBB where it is decarboxylated by dopa decarboxylase to form dopamine.
Use: alleviation of chorea if refractory to atypical
MOA: Not completely known. Inhib effects on glutamate-R, NMDA antag, Inactivation of voltage gated Na+ channels. Interferes w/ intracellular events post excitatory AA-R activation
Tetrabenxine class
MOA: Central (brain) anti-cholinergic
Use: prolong ALS survival by months
P-kinetics: Readily absorbed from intestines (depends on rate of gastric emptying and pH -- delayed by food). Some other AAs can compete for transport across the BBB.
Use: Can be used as 1st line tx for Parkinson's dz - often in combo w/ Sinemet. Commonly used to tx hyperprolactinemia.
Fluphenzaine class

You're not logged in!

Compare scores with friends on all Sporcle quizzes.
Sign Up with Email
OR
Log In

You Might Also Like...

Show Comments

Extras