drugs used for parkinson's
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dopaminergic
anticholinergic
levodopa - how is it used and why combined with carbidopa
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how used: as dopamine replacement in parkinsons undergoes
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conversion to DA in brain and activates DA receptors. |\ |\ |\ |\ |\ |\ |\ |\
why: blocks destruction of levodopa in periphery to decrease
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amount of decarboxylation so more drug can enter CNS and
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increase dopamine synthesis (ties up vitamin b 6)
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patient education levodopa
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avoid high protein meals delays drug
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can have on/off period - tell MD
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N/V common take with fruits/veggies
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monitor cardiac s/s and renal/liver function
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psychosis see MD |\ |\
what can't you combined levodopa with?
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antipsychotics decrease effectiveness |\ |\
MAO increase toxicity
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pramipexole - what is it used for? |\ |\ |\ |\ |\ |\
, - parkinsons as dopamine agonist in early stages of PD to
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improve motor function and combined with levodopa in advance
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stages to reduce fluctuations of motor control
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- restless leg syndrome
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SE pramipexole
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nausea, dizziness, somulence, insomnia, constipation,
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hallucinations, SLEEP ATTACKS & IMPULSE CONTROL DISORDERS |\ |\ |\ |\ |\ |\ |\
(screen for this) |\ |\
has less sleep attacks than other agents
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what drug increases pramipexole levels?
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cimetidine
what drug is used to treat n/v in apomorphine
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trimethobenzamide (Tigan) 3 days before taking. Cannot combine |\ |\ |\ |\ |\ |\ |\
with other antimetics risk for postural hypotension and decrease
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effectiveness of drug. |\ |\
what is apomorphine used for?
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acute hypomobility during off episodes in advance PD given by
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injection
apomorphine SE |\
Severe N/V |\
Hypotension
hyper sexuality |\
cholinesterase agents for ALZ |\ |\ |\
donzepil
galantamine
rivastigmine
which alz med is irreversible inhibition?
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