-
Carbidopa/Levadopa
- dopamine precursors
- when COMT is blocked, O-methylation is major pathway
- do not take with MAO-A inhibitors
- carbidopa decreases N by delaying conversion of DOPA until after it reaches brian.
- IR 2000mg daily; CR 1600 daily
-
Bromocriptine
- dopamine agonist
- 100mg daily
-
Pramipexole
- dopamine agonist
- renal dosing reqd
- IR & ER 4.5mg daily
-
Ropinorole
- dopamine agonist
- metabolized by 1A2
- IR 9mg daily; XL 24mg daily
- 1A2
-
Apomorphine
- dopamine agonist
- SQ injectable to treat "off" episodes
- renal adjustment reqd
- can cause SEVERE emesis
- SQ dosing pen
-
Rasagiline
- MAO irreversible inhibitor
- metabolized by 1A2
- meperidine and dextroamphetamine are contraindicated
- may cause orthostatic hyportension
-
Selegiline
- MAO irreversible inhibitor
- inhibits DA reuptake in the cleft
- metabolized by 450
- lead to methamphetamine and amphetamine metabolites
- (reduced by OTD)
- meperidine, dextroamphetamine are contraindicated
- may cause orthostatic hypotension
- PO 10mg daily; ODT 2.5mg daily
-
Entacapone
- COMT inhibitor
- bc of short half life (2 hrs), must be taken with carbidopa/Ldopa
- red urine
- 1600mg daily w/ levadopa
-
Tolcapone
- COMT inhibitor
- goes into CNS
- must monitor liver enzymes
- red urine, increase in LFTs
-
Benztropine
- anticholinergic
- eliminated via unchanged drug
- 6mg daily; PO or 1mg/ml solution
-
Trihexyphenidyl
- antichlinergic
- 15mg daily (2mg/5mL elixer)
-
Amantadine
- eliminated via glomular filtration
- can reduce dyskinesais by 70%
- 400mg daily divied doses
- syrup
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