PD Pharm

Question 1

Levodopa

Answer 1

• transported to CNS and is converted to dopamine
• ameliorates all PD symptoms
• causes significant peripheral dopaminergic effects
• GI upset, arrhythmias, diskinesia, on-off and wearing off phenomena, behavioral disturbances

-don’t use with nonspecific MAO-i

Question 2

Sinemet

Answer 2

Levo+carbi

Question 3

Stalevo

Answer 3

Levo+Carbi+Enta

Question 4

Pramipexole

Answer 4

Nonergot, direct dopamine agonist

• reduces symptoms of parkinsonism, smooths out fluctuarions in levodopa response
• can be used as a monotherapy for mild disease

Question 5

Ropnirole

Answer 5

Similar to pramipexole

• non ergot
• D2 agonist

Question 6

Bromocriptine

Answer 6

Ergot D2 agonist

Question 7

Apomorphine

Answer 7

Nonergot dopamine agonist, rescue tx for levodopa-induced dyskinesia

Question 8

Rasagiline

Answer 8

• inhibits MAO-B selectively
• smooths levodopa response
• more potent than selegiline

Question 9

Entacapone

Answer 9

COMT Inhibitor in periphery, reduces metabolism of levodopa and prolongs its action

Question 10

Tolcapone

Answer 10

COMT inhibitor, can penetrate CNS, hepatotox

Question 11

Benztropine

Answer 11

• antimuscarinic, basal ganglia

- reduces tremor and rigidity, little effect on bradykinesia