Transcript Antiparkinsonian Agents

Antiparkinsonian Agents
Ch 14
Parkinson’s Disease
• Progressive, onset @ 45-65 y.o.
• d/t imbalance between
dopamine & acetylcholine
• Symptoms:
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Slowed movement
Rigidity = cogwheel
Tremors – includes pillrolling
Postural instability
Drug Effects
• Increases body’s supply of
Dopamine
• Interferes with Acetylcholine
levels
• Restores balance & stops
symptoms
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
• Amantadine
• Causes release of more dopamine
• Also keeps dopamine available
• Anticholinergics
• Block acetylcholine
Side Effects
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Dry mouth
Palpitations
Agitation/anxiety
Severe Hypertension if taking
MAOI & eat cheese, red wine,
beer, yogurt
Psychotherapeutic
Agents
Ch 15
Mental Illness
• 3 types
• Affective = mood disorders
• Psychoses = severe emotional
disorder
• Anxiety = sense of dread or fear
Anxiolytics
• Benzodiazepines
• Valium = diazepam
• Ativan = lorazepam
• Antihistamines
• Hydroxyzine = vistaril & atarax
Anxiolytics, cont’d
• Side Effects
• Drowsiness, blurred vision
• GI upset
Antimanic
• Treat manic-depressive disorder
= bipolar
• Lithium
• Valproic acid = depakene
Antimanics, cont’d
• Mechanism of action is unclear
• Increase amount of MAO
transmitters
more
dopamine & serotonin
Antidpresssants
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Prozac
Paxil
Zoloft
Desyrel
• Alter use of serotonin in body
Antidepressants, cont’d
• Side Effects
• Weight loss
• Sweating
• Sexual dysfunction
Antipsychotic Agents
• Treat
• Psychoses
• Schizophrenia
• Autism
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’d
• Side Effects
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Postural hypotension
Sedation
Blurred vision
Parkinson-like symptoms
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
Central Nervous System
Stimulants
Ch 16
Effect
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Work on specific areas of brain
Suppress appetite
Treat ADD & ADHD
Treat narcolepsy
Treat migraine headache
amphetamines
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Treat narcolepsy & ADD
Increase mental alertness
Decrease fatigue
Highly addictive
amphetamines, cont’d
• Examples
• Adderall
• Ritalin
analeptics
• Stimulate respiration
• High abuse potential
• Examples
• Caffeine
• Aminophylline
• Theophylline
anorexiants
• Suppress appetite
• Treat obesity
• Examples
• Didrex
• Tenuate
Serotonin agonists
• Treat migraines headaches
• Constrict brain blood vessels
• Decrease inflammatory
response
• Example
• Imitrex
• Zomig
Side Effects
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Insomnia
Palpitations
Nervousness
Increased metabolism
N-V-D, dry mouth
Diuresis