NUR 3145 Pharmacology Exam 3
Questions and Answers 100% Pass
Parkinson's Disease Medications - ✔✔Mechanism of action: increase levels of
dopamine and/or antagonize effects of Ach
Indirect acting dopaminergic drugs - ✔✔selegiline (Zelapar) -indirect acting dopamine
receptor agonists (MAO-B inhibitor); inhibits the action of the enzyme monoamine
oxidase; primary role of MAO is the breakdown of catecholamines; prevents
breakdown of lepadopa
used in early stage ; adjunct drug.
Adverse effect: interaction with tyramine foods;(cheese; wine, beer , yogurt) produces
severe hypertension
MAO (monoamine oxidase) causes - ✔✔the breakdown of catecholamines in the body;
the catecholamines are epi; norepi; and dopamine.
MAO inhibitors ; selegiline and rasagiline causes an increase in the levels of
dopaminergic stimulation in the CNS; both are approved for use in combo with
carbidopa-levodopa; do not use concurrently with meperidine
Katelyn Whitman, All Rights Reserved © 2025 1
,Dopamine Modulator: - ✔✔amantadine (Symmetrel) - anti viral used in the early stage;
nerve fibers release dopamine in the basal ganglia & blocks the reuptake of dopamine
reduces tremor and rigidity; also used for influenza; effective for 6-8 months.
Adverse effects: dizziness, insomnia and nausea; this med has anticholinergic effects, if
used with other anticholinergic meds will have additive effects
COMT Inhibitor: both drugs block COMT - ✔✔talcapone (Tasmar)- adjunct drug to
carbidopa-levodopa; treats symptoms; levodopa dose-sparing effect. Works both
centrally and peripherally
entacapone (Comtan) - adjunct; Works only peripherally, can not cross BBB
Adverse effect: GI upset, urine discoloration; associated with severe liver failure.
Direct acting dopamine receptor agonist
first line agents; stimulate pre/post synaptic dopamine receptors in the brain stimulate
production of more dopamine; all dopamine agonists - ✔✔
direct acting dopamine receptor agonists (drugs) - ✔✔bromocriptine
(Parlodel)..Adverse effects: ataxia, dizziness, headache, depression, Caution: can
produce vasoconstriction in peripheral tissues; can worsen PVD
Katelyn Whitman, All Rights Reserved © 2025 2
, Pramipexole (Mirapex)..Adverse Effects: edema, fatigue, syncope, dizziness, drowsiness
Ropinirole (Requip)..Adverse effects: drowsiness; ortho hypotension
Dopamine replacement drugs: - ✔✔carbidopa-levodopa (Sinemet) - drug of choice for
elderly patients; used when patient functionally impaired. Carbidopa prevents
breakdown in periphery and thus prevents s/s of too much levodopa and also requires
lesser dose of levodopa
Large doses of levodopa:
involuntary movements, GI distress, hypotension and cardiac arrhythmias
Adverse effects: palpitations, hypotension, urinary retention, depression, dyskinesia
parkinsons adjunct meds Anti-cholinergic Drugs - ✔✔Cogentin (benztropine):
secondary drug for tremor/muscle rigidity; action is to block acetylcholine; does not
help bradykinesia; meds can cross the BBB
parkinson adjunct meds: Antihistamines:
Benadryl (diphenhydramine): secondary drug for tremor/muscle rigidity; decreases
dyskinesia; anticholinergic properties
Katelyn Whitman, All Rights Reserved © 2025 3
Questions and Answers 100% Pass
Parkinson's Disease Medications - ✔✔Mechanism of action: increase levels of
dopamine and/or antagonize effects of Ach
Indirect acting dopaminergic drugs - ✔✔selegiline (Zelapar) -indirect acting dopamine
receptor agonists (MAO-B inhibitor); inhibits the action of the enzyme monoamine
oxidase; primary role of MAO is the breakdown of catecholamines; prevents
breakdown of lepadopa
used in early stage ; adjunct drug.
Adverse effect: interaction with tyramine foods;(cheese; wine, beer , yogurt) produces
severe hypertension
MAO (monoamine oxidase) causes - ✔✔the breakdown of catecholamines in the body;
the catecholamines are epi; norepi; and dopamine.
MAO inhibitors ; selegiline and rasagiline causes an increase in the levels of
dopaminergic stimulation in the CNS; both are approved for use in combo with
carbidopa-levodopa; do not use concurrently with meperidine
Katelyn Whitman, All Rights Reserved © 2025 1
,Dopamine Modulator: - ✔✔amantadine (Symmetrel) - anti viral used in the early stage;
nerve fibers release dopamine in the basal ganglia & blocks the reuptake of dopamine
reduces tremor and rigidity; also used for influenza; effective for 6-8 months.
Adverse effects: dizziness, insomnia and nausea; this med has anticholinergic effects, if
used with other anticholinergic meds will have additive effects
COMT Inhibitor: both drugs block COMT - ✔✔talcapone (Tasmar)- adjunct drug to
carbidopa-levodopa; treats symptoms; levodopa dose-sparing effect. Works both
centrally and peripherally
entacapone (Comtan) - adjunct; Works only peripherally, can not cross BBB
Adverse effect: GI upset, urine discoloration; associated with severe liver failure.
Direct acting dopamine receptor agonist
first line agents; stimulate pre/post synaptic dopamine receptors in the brain stimulate
production of more dopamine; all dopamine agonists - ✔✔
direct acting dopamine receptor agonists (drugs) - ✔✔bromocriptine
(Parlodel)..Adverse effects: ataxia, dizziness, headache, depression, Caution: can
produce vasoconstriction in peripheral tissues; can worsen PVD
Katelyn Whitman, All Rights Reserved © 2025 2
, Pramipexole (Mirapex)..Adverse Effects: edema, fatigue, syncope, dizziness, drowsiness
Ropinirole (Requip)..Adverse effects: drowsiness; ortho hypotension
Dopamine replacement drugs: - ✔✔carbidopa-levodopa (Sinemet) - drug of choice for
elderly patients; used when patient functionally impaired. Carbidopa prevents
breakdown in periphery and thus prevents s/s of too much levodopa and also requires
lesser dose of levodopa
Large doses of levodopa:
involuntary movements, GI distress, hypotension and cardiac arrhythmias
Adverse effects: palpitations, hypotension, urinary retention, depression, dyskinesia
parkinsons adjunct meds Anti-cholinergic Drugs - ✔✔Cogentin (benztropine):
secondary drug for tremor/muscle rigidity; action is to block acetylcholine; does not
help bradykinesia; meds can cross the BBB
parkinson adjunct meds: Antihistamines:
Benadryl (diphenhydramine): secondary drug for tremor/muscle rigidity; decreases
dyskinesia; anticholinergic properties
Katelyn Whitman, All Rights Reserved © 2025 3
