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Tx for Parkinson's Disease (Loss of pigmented cells in substantia…
Tx for Parkinson's Disease (Loss of pigmented cells in substantia nigra)
Levadopa (L-dopa) -1st Line
Used in combination w/Carbidopa
Adverse Effects
N/V
Somnolence
Dizziness
Orthostatic Hypotension
DDI
Antipsychotics
Non-selective MAIOs
Benzodiazepines
Dopamine agonists (increase dopamine)
Bradykinesia relief
Dopamine Agonists
Drugs
Bromocriptine
Pramipexole
Ropinerole
Rotigotine
Adverse Effects
Edema
Fatigue
Syncope
Dizziness
GI upset
DDI
Warfarin, Ciproflaxin -> risk for toxicity
CNS depression
Hypotensive effects
Monoamine Oxidase (MOA) B inhibitors)
Drugs
Selegiline
Rasagiline
For pt's w/early PD
DDI
1A2 substrates -> serotonergic effects
5HT -> serotonin syndrome (hypertension, tachy, diaphoresis, agitation)
Adverse Effects
hypertensive crisis (avoid foods w/tyramine)
aged cheese, wine, dried meat, fermented foods
dyskinesia
hallucinations
orthostatic hypotension
Catechol-O-Methyl Transferase (COMT) inhibitors
Drugs
Entacapone
Tolcapone
Reduces tremors
DDI
MAOIs
Catecholamines
Adverse Effects
Hepatotoxicity
syncope
Orthostatic hypotension
GI upset
Anticholinergic Agents
Drugs
Trihexiphenidyl (central acting)
Benztropine (central acting)
Propantheline (central acting)
Tx for tremors/rigidity
Adverse Effects
tachycardia
confusion
constipation
Urinary retention
Dopamine Modulator
Drugs
Amantadine
Antiviral, has mild anti PD activity
Early stages of PD, reduce tremors
Adverse Effects
livedo reticularis
ankle edema
hypotension
HA
Somnolence
DDI
anticholinergics -> additive effects
Claudia Lopez
NRS 273
11/2/20