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CNS and MS relaxants
| Question | Answer |
|---|---|
| What are some signs and symptoms of Parkinson's? | Usually an insideous onset with the development of resting tremors, bradykinesia/akinesia, flat affect, rigidity, and postural instability. It usually affects people over the age of 50 |
| What are some other changes associated with Parkinson's? | Depression and other emotional changes, difficulty in swallowing, chewing, and speaking, urinary problems and constipation, sleep disruptions |
| Facts and pathophysiology of Parkinson's | Dopamine producing neurons die causing a decrease in dopamine and a relative imbalance to other NT. Causes are unkown but could be from repeated trauma, exposure to toxins or a virus, and have a predisposition. It is similar to autoimmune disorders. |
| Sinemet | combination of L-dopa(levadopa)+carbadopa (can’t be broken down in periphery) which is a replacement for dopamine |
| Levadopa | a precursor to dopamine since it does not get absorbed directly through the blood brain barrier |
| Carbadopa | allows you to utilize the existing dopamine better by keeping the enzymes in the CNS from metabolizing NT |
| Anticholenergic drugs | attempts to balance the neurotransmitters because a decrease in dopamine is like having too much Ach so we try to block it with these meds. They are believed to help with symptoms in the early stages |
| Name 2 drugs used in combination or prior to Sinemet and are dopamine agonists | Mirapex and Requip |
| MAO-B inhitors | inhibits enzymatic activity on dopamine in the synamptic cleft |
| Symmetrel | antiviral med often used in early stages or mild forms when other symptoms are worse than the tremors but they don’t know why it works |
| Co enzyme Q10 | considered vitamin like and endogenoush and given in megadosis it can stimulate mitochondria in dopamine producing cells |
| Adverse drug reactions of Sinemet | 1. Dyskinesia where you have dynamic and involuntary movements "athetoid movements" 2. periods of "wearing off" where it is like you are off the medications. there can be a sudden change within seconds to minutes. |
| Positive effects of Sinemet | Increase in movement velocity but still have trouble with a burst of activity and a decrease in tremor and rigidity |
| Negative effects of Sinemet | Decrease in LE tone, decrease reaction time, increased falls, GI symptoms leading to thinness, hypotention, anxiety psychosis, hallucinations, paranoia, and confusion |
| Name 2 immunosuppressants for MS | Methotrexate and Novandone |
| Name 3 immunomodulators for MS | 1.Avonex- IM injection 1/wk 2.Rebif- subcutaneous injection 3x/wk 3.Betaseron- subcutaneous injection every other day |
| Copaxone | acts as a myelin decoy and avoids flu like symptoms but has to be given every day |
| Gilenya | First oral drug for MS 66% decrease in number of flares |
| Tysabri | there is a mandatory registration if you are on this drug because there is a chance of developing Progressive Multifocal Leukoencephalopathy (PML) |
| Name 2 drugs for treatment of Alzheimer's | Exelon and Aricep |
Created by:
badkins6
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