Parkinsons

Created by: Rosa
Created on: 12-05-13 17:56

Selegiline (Deprenyl)

slectivley inhibits MAO-b and reduces dopamine breakdown. prolongs L-dopa action allowing dose to be reduced (1/3) but inc adverse SE. Mild anti-park activity but delay need for L-dop [slow progression] S.E= nausea, abdominal pain, insomnia, confusio

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D2 agonists (amantadine)

2 situations: initial therapy in young, avoid development of on-off response. reduce on-off response. Dyskinesia may be slowed but only upto 50% show benefit. SE= constip, peripheral vasospams, hypotension. tolerance and confusion w/inc dose.

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L-dopa (levodopa)

inactivated by MAO-b (intestine) convert to dopamine by dopa-decarboxylase (cannot cross bb.barrier) so carbidopa given aswell to inhibit dopa-decar resulting in 10 fold less dopa admin(less S.E) 1/2 life= 2hrs so regular admin.

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cont...

L-dopa converted bt COMT to 3-o-methyl dopa in periphery (10% get into body) Neurons of basal ganglia convert to dopamine. 1st line treat: levodopa and carboxylase inhib [effect declines 2-5years] inc S.E in time: dyskinesia, bradykinesia,

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cont 2...

muscle ridgidity and depression more sever. psychiatric effects most limiting: vivid dreams, hallucinations, schizoid. Potential hypotension

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Anticholinergics (Benzatropine)

MUSCARINIC CHOLINERGIC ANTAGONISTS useful in controlling tremor. modest improvemnet in early disease. S.E= dry mouth, urinary retention and constipation. psyc: decreased memory and conc plus confusion w/hallucinations.

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D2 agonists (amantadine)

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Card 3

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L-dopa (levodopa)

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Card 4

Front

cont...

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Card 5

Front

cont 2...

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Parkinsons