Movement Disorders Drugs

Random Miscellaneous Quiz

Can you name the Movement Disorders Drugs?

Quiz not verified by Sporcle

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

Friend Scores


  Player Best Score Plays Last Played
You You haven't played this game yet.

You Might Also Like...

Extras

Created Oct 8, 2011ReportNominate
Tags:disorder, drug, movement