Fichas
Parkinson therapy
Fichas del conjunto (7)
- 1Levodopa + DDI --sinemet (co-careldopa), madopar (co-beneldopa)Gets absorbed from small intestine
half-life of 1 hr
*most effective drug (improve motor symptoms)
s/e: short term (GI, postural hypotension, sleep disorder;nightmares, psychiatric; hallucination), long term (dyskinesia, response fluctuation) - 2Dopamine agonists --Ropinirole (warfarin enhances its effect), Pramipexole, Apomorphine (NON-ergot)Acts directly on D1/D1 receptor in striatum
half-life <24hr
Apomorphine use to improve the 'off' symptoms (but not to prevent)
s/e: GI, postural hypo, sleep disorder, psychiatric (IMPULSE control disorder) - 3MAO-B inhibitor --selegiline, rasagilineirreversible inhibitor; decreases breakdown of dopamine, possible neuroprotective
useful in YOUNGER patients (to avoid L-dopa dyskinesia)
s/e: GI, confusion, serotonin syndrome, AF - 4COMT inhibitor --entacaponeCOMT breaks down Levodopa
Stalevo (sinemet+entacapone)
s/e: diarrhoea, fluid discoloration, increases dyskinesia - 5AmantadineAntiviral; NMDA receptor antagonist--> DA release increased
Given at later stages, Treat dyskinesias
s/e: confusion, hallucinations, psychosis, livedo reticularis, ankle edema - 6Anticholinergics (not commonly used) --benzhexol, orphenadrineRarely used except in young patients with prominent tremor
decrease effect of central Ach excess (due to dopaminergic deficiency)
s/e: cognitive impairment (CI in elderly), anti-SLUD, dizziness, blurred vision, glaucoma, anxiety, confusion - 7Drug-induced parkinsonismHigh risk:
Dopamine antagonists
-->Neuroleptics e.g haloperidol, risperidone, olanzapine
-->Anti-emetics e.g metoclopramide, prochlorperazine
Valproate
Lithium
Calcium channel blockers
SSRIs e.g fluoxetine
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- Medicine Fichas sobre Parkinson therapy, creado por Crystal Wong el 29/11/2018.
- Creado por
- Crystal Wong
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