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Antiparkinsonian Agents. Ch 14. Parkinson’s Disease. Progressive, onset @ 45-65 y.o. d/t imbalance between dopamine & acetylcholine Symptoms: Slowed movement Rigidity = cogwheel Tremors – includes pillrolling Postural instability. Drug Effects. Increases body’s supply of Dopamine

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parkinson s disease
Parkinson’s Disease
  • Progressive, onset @ 45-65 y.o.
  • d/t imbalance between dopamine & acetylcholine
  • Symptoms:
    • Slowed movement
    • Rigidity = cogwheel
    • Tremors – includes pillrolling
    • Postural instability
drug effects
Drug Effects
  • Increases body’s supply of Dopamine
  • Interferes with Acetylcholine levels
  • Restores balance & stops symptoms
medications
Medications
  • MAO Inhibitors
    • Eldepryl = Selegiline
    • Slows the breakdown of Dopamine
    • Used with Levodopa
  • Exogenous Dopamine
    • Levodopa
    • Levodopa-carbidopa
    • Replaces low levels of dopamine
meds cont d
Meds, cont’d
  • Amantadine
    • Causes release of more dopamine
    • Also keeps dopamine available
  • Anticholinergics
    • Block acetylcholine
side effects
Side Effects
  • Dry mouth
  • Palpitations
  • Agitation/anxiety
  • Severe Hypertension if taking MAOI & eat cheese, red wine, beer, yogurt
mental illness
Mental Illness
  • 3 types
    • Affective = mood disorders
    • Psychoses = severe emotional disorder
    • Anxiety = sense of dread or fear
anxiolytics
Anxiolytics
  • Benzodiazepines
    • Valium = diazepam
    • Ativan = lorazepam
  • Antihistamines
    • Hydroxyzine = vistaril & atarax
anxiolytics cont d
Anxiolytics, cont’d
  • Side Effects
    • Drowsiness, blurred vision
    • GI upset
antimanic
Antimanic
  • Treat manic-depressive disorder = bipolar
  • Lithium
  • Valproic acid = depakene
antimanics cont d
Antimanics, cont’d
  • Mechanism of action is unclear
  • Increase amount of MAO transmitters more dopamine & serotonin
antidpresssants
Antidpresssants
  • Prozac
  • Paxil
  • Zoloft
  • Desyrel
  • Alter use of serotonin in body
antidepressants cont d
Antidepressants, cont’d
  • Side Effects
    • Weight loss
    • Sweating
    • Sexual dysfunction
antipsychotic agents
Antipsychotic Agents
  • Treat
    • Psychoses
    • Schizophrenia
    • Autism
antipsychotics cont d
Antipsychotics, cont’d
  • Phenothiazines
    • Largest group of antipsychotics
    • Chlorpromazine (Thorazine) was the 1st discovered
    • Similar to antihistamines
    • Block reception of Dopamine
    • Do not cure, only control symptoms
antipsychotics cont d1
Antipsychotics, cont’d
  • Side Effects
    • Postural hypotension
    • Sedation
    • Blurred vision
    • Parkinson-like symptoms
precautions
Precautions
  • Do NOT take MAOI meds with alcohol, yeast, yogurt products
  • Do NOT abruptly stop antidepressents – must wean off
  • When starting, It may take up to 2 – 4 weeks to reach therapeutic level
  • Caffeine limits effectiveness of meds
effect
Effect
  • Work on specific areas of brain
  • Suppress appetite
  • Treat ADD & ADHD
  • Treat narcolepsy
  • Treat migraine headache
amphetamines
amphetamines
  • Treat narcolepsy & ADD
  • Increase mental alertness
  • Decrease fatigue
  • Highly addictive
amphetamines cont d
amphetamines, cont’d
  • Examples
    • Adderall
    • Ritalin
analeptics
analeptics
  • Stimulate respiration
  • High abuse potential
  • Examples
    • Caffeine
    • Aminophylline
    • Theophylline
anorexiants
anorexiants
  • Suppress appetite
  • Treat obesity
  • Examples
    • Didrex
    • Tenuate
serotonin agonists
Serotonin agonists
  • Treat migraines headaches
  • Constrict brain blood vessels
  • Decrease inflammatory response
  • Example
    • Imitrex
    • Zomig
side effects1
Side Effects
  • Insomnia
  • Palpitations
  • Nervousness
  • Increased metabolism
  • N-V-D, dry mouth
  • Diuresis